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NY A03789
Bill
Status
1/30/2025
Primary Sponsor
David Weprin
Click for details
AI Summary
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Requires utilization review agents to use evidence-based and peer-reviewed clinical review criteria that account for the needs of typical patient populations and diagnoses when making coverage determinations
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Shortens the deadline for pre-authorization decisions from three business days to 72 hours for health care services requiring prior approval
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Mandates that approved pre-authorizations remain valid for the full duration of a prescription, including all authorized refills
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Extends pre-authorization validity for the entire duration of treatment for a specific condition as requested by the enrollee's health care provider
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Takes effect 180 days after becoming law
Legislative Description
Relates to utilization review program standards; requires use of evidence-based and peer reviewed clinical review criteria; relates to prescription drug formulary changes and pre-authorization for certain health care services.
Last Action
amend by restoring to original print 3789
2/10/2026