"Urgent Care Situation"

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Sec. 8. As used in this chapter, "urgent care situation" means a situation in which a covered individual's treating physician has determined that the covered individual's condition is likely to result in:

(1) adverse health consequences or serious jeopardy to the covered individual's life, health, or safety; or

(2) due to the covered individual's psychological state, serious jeopardy to the life, health, or safety of another individual;

unless treatment of the covered individual's condition for which prior authorization is sought occurs earlier than the period generally considered by the medical profession to be reasonable to treat routine or non-life threatening conditions.

As added by P.L.77-2018, SEC.2.


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