Prior authorization; exceptions

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20-3402. Prior authorization; exceptions

A. A health care services plan or its utilization review agent may impose a prior authorization requirement for health care services provided to an enrollee, except for emergency ambulance services and emergency services as specified in section 20-2803, health care services arising after the initial medical screening examination and immediately necessary stabilizing treatment as specified in section 20-2803.

B. A health care services plan must allow at least one modality of medication-assisted treatment to be available without prior authorization.


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