Section 59A-22B-7 - Prior authorization or referral requirement for in-network mental health or substance use disorder services coverage prohibitedA. A health insurer shall not require prior authorization and referral requirements for the following mental health or substance use disorder services:(1) acute or immediately necessary care;(2) acute episodes of chronic mental health or substance use disorder conditions; or(3) initial in-network inpatient or outpatient substance use treatment services.B. Prior authorization shall be determined in consultation with the insured's mental health or substance use disorder services provider for: (1) continuation of services in chronic or stable conditions; orC. Except in cases in which the insured terminates a plan, a health insurer shall not terminate coverage of services without consultation with the insured's mental health or substance use disorder services provider.D. A health insurer shall not limit coverage for mental health or substance use disorder services up to the point of relief of presenting signs and symptoms or to short-term care or acute treatment.E. The duration of coverage for an insured with a mental health or substance use disorder shall be based on the mental health or substance use disorder needs of the insured rather than on arbitrary time limits.F. A health insurer may require a mental health or substance use disorder services provider to provide notification to the health insurer after the initiation of in-network mental health or substance use disorder treatment pursuant to Subsection A of this section.G. If a provider fails to notify a health insurer pursuant to Subsection F of this section, a health insurer may perform appropriate utilization review.H. A health insurer may require a mental health or substance use disorder services provider to develop and submit a treatment plan for an insured receiving in-network services in a manner that is compliant with federal law.Added by 2023, c. 114,s. 12, eff. 6/13/2023.