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New Jersey · Through P.L.2025, c.405, and J.R.22 · Newer source version available

N.J. Stat. § 17B:30-55.16: Statistics available regarding prior authorization approvals, denials, website.

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  1. TITLE 17B INSURANCE

17. A payer shall make statistics available regarding prior authorization approvals and denials on its Internet website in a readily accessible format, as determined by the commissioner. Payers shall include categories for:

a. health care provider specialty;

b. medication or diagnostic tests and procedures;

c. indication offered;

d. reason for denial;

e. whether prior authorization determinations were:

(1) appealed; or

(2) approved or denied on appeal;

f. the time between submission of prior authorization requests and the determination;

g. the average median time elapsed between a request for clinical records from the requesting health care provider and receipt of adequate clinical records to complete the prior authorization; and

h. the number of appeals generated for cases denied in which there was inadequate or no prior clinical information.

L.2023, c.296, s.17.

Collected 2026-08-27T17:54:13Z. Source file · JSON

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