§ 26-55-110 — Length of authorization generally; revocation of prior authorizations prohibited; length of authorization for chronic or long-term care conditions

Wyoming § 26-55-110

• Jurisdiction: Wyoming
• Title 26: Insurance Code
• Ch. 55: ENSURING TRANSPARENCY IN PRIOR AUTHORIZATION ACT

Text

(a) Each authorization shall have the following timelines:
(i) Outpatient service prior authorizations shall be
valid for a period of not less than one (1) year;
(ii) Prescription drug authorization periods shall be
effective for a period of not less than one (1) year including
changes in dosage for a prescription drug prescribed by a health
care provider, provided that the authorization period and dosage
change are consistent with dosing and duration according to
evidence-based guidelines for safety and efficacy;
(iii) Prior authorizations for inpatient services
shall be valid for a length of time based on the patient's
clinical condition. This period will be not less than one (1)
day.
(b) Each health insurer or contracted utilization review
entity shall not revoke, limit, condition or restrict a
previously approved authorization for health care services if
the health care services are provided within forty-five (45)
business days from the date the health care provider received
the authorization approval for the specific service that was
authorized.
(c) If a health insurer or contracted utilization review
entity requires a prior authorization request for a health care
service for the treatment of a chronic or long-term care
condition, the authorization shall remain valid for one (1)
year. This section shall not apply to the prescription of
benzodiazepines or schedule II narcotic drugs.