Effective July 1, 2026
58-17H-58. Utilization review organization or health carrier--Health care service review--Prior authorization requirement elimination.
A utilization review organization or health carrier shall annually review each health care service for which a health benefit plan requires prior authorization and shall eliminate the prior authorization requirement for any health care service if prior authorization requests are routinely approved with such frequency as to demonstrate that the prior authorization requirement does not promote health care quality or reduce health care spending, to a degree that justifies the plan's administrative costs associated with the prior authorization requirement.