Source: http://delcode.delaware.gov/title18/c033/sc02/
Timestamp: 2019-03-26 13:29:09
Document Index: 93030246

Matched Legal Cases: ['§ 3371', '§ 3372', '§ 3373', '§ 3374', '§ 3375', '§ 3376', '§ 3377', '§ 3378', '§ 3379', '§ 3380', '§ 3371', '§ 1', '§ 3372', '§ 3373', '§ 3374', '§ 3375', '§ 3376', '§ 3372', '§ 3372', '§ 3377', '§ 3378', '§ 3379', '§ 3380']

TITLE 18 - CHAPTER 33. HEALTH INSURANCE CONTRACTS - Subchapter II. Pre-Authorization Transparency
§ 3371 § 3372 § 3373 § 3374 § 3375 § 3376 § 3377 § 3378 § 3379 § 3380
Subchapter II. Pre-Authorization Transparency
§ 3371 Definitions.
(4) "Covered person" means an individual and/or family who has entered into a contractual arrangement, or on whose behalf a contractual arrangement has been entered into, with a carrier, pursuant to which the carrier provides health insurance for such person or persons.
(5) "Electronic pre-authorization" [ePA] means a submission of information via a website, the Delaware Health Information Network, or other method via the Internet as delineated by regulation and as accepted by the utilization review entity. Electronic pre-authorization does not include any form of request that is transmitted to the utilization review entity through facsimile.
80 Del. Laws, c. 310, § 1.;
§ 3372 Disclosure and review of pre-authorization requirements.
§ 3373 Utilization review entity's obligations with respect to pre-authorizations in nonemergency circumstances.
§ 3374 Utilization review entity's obligations with respect to pre-authorization concerning emergency health-care services.
§ 3375 Retrospective denial.
§ 3376 Length of pre-authorization.
(a) A pre-authorization for pharmaceuticals shall be valid for 1 year from the date the health-care provider receives the pre-authorization, subject to confirmation of continued coverage and eligibility and to policy changes validly delivered as per § 3372 of this title and except as otherwise set by evidence-based treatment protocol.
(b) A pre-authorization for a health-care service shall be valid for a period of time that is reasonable and customary for the specific service, but no less than 60 days, from the date the health-care provider receives the pre-authorization, subject to confirmation of continued coverage and eligibility and to policy changes validly delivered as per § 3372 of this title.
§ 3377 Electronic standards for pharmaceutical pre-authorization.
§ 3378 Health-care services deemed preauthorized if a utilization review entity fails to comply with the requirements of this subchapter.
§ 3379 Waiver prohibited.
§ 3380 Exemptions.