NY Ins L §4903(c)(1)

August 8, 2021 2:19 am Published by

(c)(1) A utilization review agent shall make a determination involving continued or extended health care services, additional services for an insured undergoing a course of continued treatment prescribed by a health care provider, or requests for inpatient substance use disorder treatment, or home health care services following an inpatient hospital admission, and shall provide notice of such determination to the insured or the insured’s designee, which may be satisfied by notice to the insured’s health care provider, by telephone and in writing within one business day of receipt of the necessary information…Notification of continued or extended services shall include the number of extended services approved, the new total of approved services, the date of onset of services and the next review date.

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