Alaska Statutes Title 21. Insurance § 21.07.110. Prior authorization standards

(a) A health care insurer shall make its most current prior authorization standards available to a covered person and health care provider on the health care insurer's Internet website, including information or documentation to be submitted by the covered person or health care provider or facility.  If the health care insurer provides a portal, the insurer shall also make the prior authorization standards available on the portal.  A health care insurer shall describe the standards in detailed, easily understood language.

(b) A health care insurer's prior authorization standards must include prior authorization requirements used by the insurer and by the insurer's utilization review organizations.  The prior authorization requirements must be based on peer-reviewed, evidence-based clinical review criteria and be consistently applied by all sources, including utilization review organizations, to avoid discrepancies or conflicts.  The health care insurer shall evaluate and, if necessary, update the clinical review criteria at least annually.

(c) If the prior authorization standards published by the health care insurer differ from those published by the health care insurer's utilization review organization, the health care insurer shall use the prior authorization standard most favorable to the covered person.

(d) A health care insurer shall indicate on its Internet website, for each service subject to prior authorization,