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Current as of January 01, 2024 | Updated by Findlaw Staff
A prior authorization review organization shall ensure all adverse determinations are made by a licensed physician or licensed pharmacist. The reviewing individual:
1. Must have experience treating patients with the condition or illness for which the health care service is being requested; and
2. Shall make the adverse determination under the clinical direction of one of the prior authorization review organization's medical directors who is responsible for the health care services provided to enrollees.
Cite this article: FindLaw.com - North Dakota Century Code Title 26.1. Insurance § 26.1-36.12-03. Personnel qualified to make adverse determinations - last updated January 01, 2024 | https://codes.findlaw.com/nd/title-26-1-insurance/nd-cent-code-sect-26-1-36-12-03/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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