Nevada Code § 422.3072

Time period for response to request for prior authorization
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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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