Nebraska § 44-5442 - Prior authorization; change in utilization review agent, coverage of or approval criteria for health care service, or health insurance product; effect.

§ 44-5442. Prior authorization; change in utilization review agent, coverage of or approval criteria for health care service, or health insurance product; effect.

(1) On receipt of information documenting an approved prior authorization from the enrollee or from the enrollee's health care provider, a utilization review agent shall honor the approved prior authorization granted to an enrollee from a previous utilization review agent for at least the initial sixty days of an enrollee's coverage under a new health benefit plan. During such time period, a utilization review agent may perform its own review to grant a prior authorization.

(2) If there is a change in coverage of, or approval criteria for, a previously authorized health care service, the change in coverage or approval criteria does not affect a prior authorization request approved before the effective date of the change.

(3) A utilization review agent shall continue to honor a prior authorization it has granted to an enrollee when the enrollee changes health insurance products under the same health insurance company without any action required by the health care provider.