Health insurance; prior authorization; utilization review organizations; insurers; exemptions; effective date.

Summary

It requires utilization review organizations to approve, deny, or acknowledge a prior‑authorization request within 72 hours plus one business day. If the insurer asks the provider for more information, it must make a decision within another 72 hours plus one business day after receiving that information. Network providers must submit all clinical data within six calendar days, and insurers must give providers a direct phone number and hours for discussing medical necessity.

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