1. Unless a shorter time period is prescribed by a specific statute, and except as otherwise provided in subsection 2, the Authority or a Medicaid managed care entity, with respect to Medicaid and the Childrens Health Insurance Program, shall respond to a request for prior authorization submitted by or on behalf of a recipient within: (a) Two business days after receiving the request; or (b) If the Prior Authorization and Referrals Operating Rules prescribed by the Committee on Operating Rules for Information Exchange of the Council for Affordable Quality Healthcare, or its successor organization, would allow the Authority or Medicaid managed care entity more than 2 business days to respond to a particular request for prior authorization after receiving the request, the period of time prescribed by the Rules. 2. Notwithstanding any period of time prescribed by the Rules described in paragraph (b) of subsection 1, the Authority or a Medicaid managed care entity shall respond to a request for prior authorization within 7 calendar days after receiving the request. 3. The Authority, in collaboration with the Commissioner of Insurance, shall review each revision to the Rules described in paragraph (b) of subsection 1 to ensure their suitability for Medicaid coverage in this State. If the Authority determines that a revision is not suitable for Medicaid coverage in this State, the Authority shall give notice within 30 days after the hearing that the revisions are not suitable for Medicaid coverage in this State. If the Authority gives such notice, the Authority or a Medicaid managed care entity shall respond to any request for prior authorization that is submitted to the Authority or Medicaid managed care entity, as applicable, after the date on which such notice is given within 2 business days after receiving the request.
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