44-5442. Prior authorization; change in utilization review agent, coverage of or approval criteria for health care service, or health insurance product; effect.
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/ne/chapter-44/44-5442A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(1)On receipt of information documenting an approved prior authorization from the enrollee or from the enrollee's health care provider, a utilization review agent shall honor the approved prior authorization granted to an enrollee from a previous utilization review agent for at least the initial sixty days of an enrollee's coverage under a new health benefit plan. During such time period, a utilization review agent may perform its own review to grant a prior authorization.
(2)If there is a change in coverage of, or approval criteria for, a previously authorized health care service, the change in coverage or approval criteria does not affect a prior authorization request approved before the effective date of the change.
(3)A utilization review agent shall continue to honor a prior authorization it has granted to an enrollee when the enrollee changes health insurance products under the same health insurance company without any action required by the health care provider.