North Dakota § 26.1-36.12-12 Continuity of care for enrollees

North Dakota Statutes

§ 26.1-36.12-12 — Continuity of care for enrollees

North Dakota § 26.1-36.12-12

Title 26.1Insurance

Ch. 26.1-36.12Prior Authorization for Health Insurance

This text of North Dakota § 26.1-36.12-12 (Continuity of care for enrollees) is published on Counsel Stack Legal Research, covering North Dakota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

N.D. Cent. Code § 26.1-36.12-12 (2026).

Text

1.On receipt of information documenting a prior authorization from the enrollee or from the enrollee's health care provider, a prior authorization review organization shall honor a prior authorization granted to an enrollee from a previous prior authorization review organization for at least the initial sixty days of an enrollee's coverage under a new policy, provided the health care service for which the enrollee has received prior authorization is covered under the new policy. To obtain coverage, the enrollee or health care provider shall submit documentation of the previous prior authorization in accordance with the procedures in the enrollee's new policy.

2.During the time period described in subsection 1, a prior authorization review organization may perform its review to grant a pr

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1. On receipt of information documenting a prior authorization from the enrollee or from
the enrollee's health care provider, a prior authorization review organization shall
honor a prior authorization granted to an enrollee from a previous prior authorization
review organization for at least the initial sixty days of an enrollee's coverage under a
new policy, provided the health care service for which the enrollee has received prior
authorization is covered under the new policy. To obtain coverage, the enrollee or
health care provider shall submit documentation of the previous prior authorization in
accordance with the procedures in the enrollee's new policy.
2. During the time period described in subsection 1, a prior authorization review
organization may perform its review to grant a prior authorization.
3. If there is a change in coverage of, or approval criteria for, a previously authorized
health care service, the change in coverage or approval criteria does not affect an
enrollee who received prior authorization before the effective date of the change for
the remainder of the enrollee's plan year. This subsection does not apply if a prior
authorization review organization changes coverage terms for a drug or device that
has been:
a. Deemed unsafe by the United States food and drug administration; or
b. Withdrawn by the United States food and drug administration or product
manufacturer.
4. A prior authorization review organization shall continue to honor a prior authorization
the organization has granted to an enrollee if the enrollee changes products under the
same health insurance company provided the health care service for which the
enrollee has received prior authorization is covered under the new policy.