Ensuring Transparency in Prior Authorization Act imposes requirements and limitations on prior authorization in healthcare.
The Ensuring Transparency in Prior Authorization Act sets rules for prior authorization in healthcare, including time limits for responses and requirements for electronic submissions. Utilization review entities must respond to urgent healthcare service requests within two hours and regular service requests within three calendar days. They must also use a secure electronic portal for prior authorization requests at no cost to healthcare providers. The act prohibits retroactive denials of prior authorization and requires annual reporting on prior authorization practices.
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- Overview
- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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