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Current as of January 01, 2024 | Updated by Findlaw Staff
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.
Cite this article: FindLaw.com - New Jersey Statutes Title 17B. Insurance 17B § 30-55.6 - last updated January 01, 2024 | https://codes.findlaw.com/nj/title-17b-insurance/nj-st-sect-17b-30-55-6/
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