New Jersey § 17B:30-55.16 Statistics available regarding prior authorization approvals, denials, website.

New Jersey Statutes

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

New Jersey § 17B:30-55.16

Title 17BINSURANCE

This text of New Jersey § 17B:30-55.16 (Statistics available regarding prior authorization approvals, denials, website.) is published on Counsel Stack Legal Research, covering New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

N.J. Stat. Ann. § 17B:30-55.16 (2026).

Text

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

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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.