33-46-28. Honoring of prior authorizations.

Upon receipt of information documenting a prior authorization from a covered person or from a covered person’s healthcare provider, a private review agent or utilization review entity, for at least the initial 30 days of such person’s new coverage, shall honor a prior authorization for a covered healthcare service granted to him or her from a previous private review agent or utilization review entity even if approval criteria or products of a healthcare plan have changed or such person is covered under a new healthcare plan, so long as the former criteria, products, or plans are not binding upon a new insurer.#

During the time period described in subsection (a) of this Code section, a private review agent or utilization review entity may perform its own review to grant a prior authorization.#

If there is a change in coverage of, or approval criteria for, a previously authorized healthcare service, the change in coverage or approval criteria shall not affect a covered person who received prior authorization before the effective date of such change for the remainder of the covered person’s plan year so long as such person remains covered by the same insurer.#

A private review agent or utilization review entity shall continue to honor a prior authorization it has granted to a covered person in accordance with this Code section.#