Wyoming § 26-55-113 Prior authorization for rehabilitative or
habilitative services

Wyoming Statutes

§ 26-55-113 — Prior authorization for rehabilitative or habilitative services

Wyoming·Title 26 Insurance Code·Ch. 55 ENSURING TRANSPARENCY IN PRIOR AUTHORIZATION ACT

(a)A health insurer or contracted utilization review entity shall not require prior authorization for rehabilitative or habilitative services including, but not limited to, physical therapy services or occupational therapy services for the first twelve (12) visits for each new episode of care. For purposes of this subsection, "new episode of care" means treatment for a new condition or treatment for a recurring condition that an enrollee has not been treated within the previous ninety (90) days.

(b)This section does not limit the right of a health insurer or contracted utilization review entity to deny a claim when an appropriate prospective or retrospective review concludes that the health care services were not medically necessary.

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(a) A health insurer or contracted utilization review
entity shall not require prior authorization for rehabilitative
or habilitative services including, but not limited to, physical
therapy services or occupational therapy services for the first
twelve (12) visits for each new episode of care. For purposes of
this subsection, "new episode of care" means treatment for a new
condition or treatment for a recurring condition that an
enrollee has not been treated within the previous ninety (90)
days.
(b) This section does not limit the right of a health
insurer or contracted utilization review entity to deny a claim
when an appropriate prospective or retrospective review
concludes that the health care services were not medically
necessary.

Wyoming § 26-55-113 (Prior authorization for rehabilitative or habilitative services) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.