Effect of change in prior authorization clinical criteria
N.D. Cent. Code § 26.1-36.12-15
in effect26.1-36.12-15. Effect of change in prior authorization clinical criteria
1. If, during a plan year, a prior authorization review organization changes coverage
terms for a health care service or the clinical criteria used to conduct prior
authorizations for a health care service, the change in coverage terms or in clinical
criteria does not apply until the next plan year for any enrollee who received prior
authorization for a health care service using the coverage terms or clinical criteria in
effect before the effective date of the change.
2. This section does not apply if a prior authorization review organization changes
coverage terms for a drug or device that has been:
a. Deemed unsafe by the United States food and drug administration; or
b. Withdrawn by the United States food and drug administration or product
manufacturer.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://ndlegis.gov/cencode/t26-1c36-12.pdf#nameddest=26p1-36p12-15Fetched: 10/16/2026