A utilization review organization or health carrier shall submit an annual report to the Division of Insurance, at the time and in the manner requested by the division, regarding the review required in accordance with § 58-17H-58 . The report must set forth: (1) The number of prior authorizations evaluated in accordance with the review; (2) The number of prior authorizations eliminated as a result of the review, and the reason for the elimination; (3) The list of prior authorizations that had at least eighty percent of all requests approved, during the preceding calendar year, for a specific health care service covered by the health benefit plan, but for which the prior authorization requirement was retained due to medical or scientific evidence that justified continuation of the requirement; and (4) The number of prior authorization requests that were submitted in the preceding calendar year for each eliminated prior authorization and the number of health care providers that had submitted a request for each eliminated prior authorization requirement. With respect to each health care service for which prior authorization was eliminated under § 58-17H-58 , the report must provide data regarding any increase or decrease of ten percent or more, in the average number of claims submitted per health care provider, for that service, compared to the calendar year preceding the elimination. The division shall publish the report required by this section on the division's website within sixty days after receiving the report.
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