New Law Improves Response Times for Prior Authorization Requests



On January 16, 2024, Governor Murphy signed into law Bill A1255 implementing standards for prior authorizations of health care services. The new law shortens the timeframe in which a payer must make a determination regarding prior authorizations and details the difference in timeframes for urgent versus nonurgent requests. For instance, a payer has 24 hours to respond to a prior authorization urgent request for medication and 72 hours for a nonurgent request. For diagnostics and procedures, the timeframe is 72 hours for urgent requests and 9 days for nonurgent requests, if the request is submitted electronically. Additionally, missed deadlines will result in automatic authorizations. The new law also provides for peer review of any denials or limitations imposed by a payer.

Click Here to read the entire January 2024 Healthcare Law Update now!

For more information, contact:
John D. Fanburg, Chair | 973.403.3107 |
Edward Hilzenrath | 973.403.3114 |
Erika R. Marshall | 973.364.5236 |

*This is intended to provide general information, not legal advice. Please contact the authors if you need specific advice.

Related Practices:   Healthcare Law

Related Industry:   Healthcare