New York A03789 amends health care standards to require evidence-based clinical review criteria and faster pre-authorization for certain services.

New York A03789 amends the public health law and insurance law to enhance utilization review program standards. It mandates the use of evidence-based and peer-reviewed clinical review criteria in health care decisions, ensuring they consider typical patient populations and diagnoses. The bill also expedites pre-authorization for certain health care services, requiring decisions within 72 hours for standard cases and within 24 hours for urgent situations. Additionally, it mandates that pre-authorization approvals cover the duration of the prescription and the treatment of a specific condition.

New York A03789 amends health care standards to require evidence-based clinical review criteria and faster pre-authorization for certain services.

New York A03789 amends the public health law and insurance law to enhance utilization review program standards. It mandates the use of evidence-based and peer-reviewed clinical review criteria in health care decisions, ensuring they consider typical patient populations and diagnoses. The bill also expedites pre-authorization for certain health care services, requiring decisions within 72 hours for standard cases and within 24 hours for urgent situations. Additionally, it mandates that pre-authorization approvals cover the duration of the prescription and the treatment of a specific condition.