17B:30-55.6 Carrier, respond, prior authorization requests, medication coverage submitted, NCPDP SCRIPT Standard for ePA transactions.
105 words·~1 min read·
/nj/title-17b/chapter-30/17b-30-55-6·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
7. a. A carrier shall respond to prior authorization requests for medication coverage submitted using the NCPDP SCRIPT Standard for ePA (electronic prior authorization) transactions, under the pharmacy benefit part of a health benefits plan, within 24 hours for urgent requests and 72 hours for non-urgent requests after obtaining all necessary information to make the approval or adverse determination.
b. Beginning January 1, 2027, a carrier shall only accept and respond to prior authorization requests for medication coverage, under the pharmacy benefit part of a health benefits plan submitted through a secure electronic transmission using the NCPDP SCRIPT Standard for ePA transactions.
L.2023, c.296, s.7.