33-32-209. (Effective January 1, 2026) Exemption for continuity of care on change in health plans.
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33-32-209 . (Effective January 1, 2026) Exemption for continuity of care on change in health plans.
(1)When a covered person changes health plans, a health insurance issuer or its utilization review organization shall honor a certification for health care services granted by a previous health insurance issuer or its utilization review organization for at least the first 3 months of the person's coverage under a new health plan on receiving information documenting the certification from the covered person or the person's health care provider, provided that the services are covered services under the new plan.
(2)During the time period specified in subsection (1), a utilization review organization may perform its own review to grant certification.
(3)If a change in coverage or approval criteria occurs for a previously certified health care service, the change in coverage or approval criteria does not affect a covered person who received certification for a health care service before the effective date of the change for the remainder of the authorization period or the covered person's plan year, whichever is shorter.
(4)A utilization review organization shall continue to honor a certification for health care services it has granted to a covered person when the person changes to a product offered by the same health insurance issuer, provided that the services are covered under the new plan.