Prior authorization, defined number, discrete services, set time frame, validity, exception.
N.J. Stat. § 17B:30-55.9
in effect10. Except where shorter time frames are necessary to monitor patient safety or treatment effectiveness and with notice to the treating provider, prior authorization for a service which includes a defined number of discrete services within a set time frame shall be valid for purposes of authorizing the health care provider to provide care for a period of 180 days from the date the provider receives the prior authorization and a payer shall not revoke, limit, condition or restrict a prior authorization within that period if (1) the covered person continues to be eligible for coverage; (2) the clinical information provided at the time the prior authorization request was made has not been misrepresented by the treating physician or covered person; and (3) there has not been a material change in the clinical circumstances or condition of the covered person. L.2023, c.296, s.10.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://www.njleg.state.nj.us/legislative-activity/statutesFetched: 10/17/2026