Revises provisions relating to prior authorization. (BDR 57-825)

Replaced references to private insurers with the Department of Health and Human Services regarding the requirement to publish prior authorization procedures and clinical review criteria on an Internet website.

Updated the Legislative Counsel's Digest to reflect that the Department, not private insurers, must approve or deny requests for prior authorization and handle appeals for Medicaid and CHIP fee-for-service beneficiaries.

Added a presumption of medical necessity for covered medically necessary emergency services under specific conditions.

Clarified that prior authorization approvals are valid for 12 months or until treatment standards change for chronic conditions, applying to both private insurers and public programs.

Response time for prior authorization requests was reduced from 20 days to 2 business days for private insurers and Medicaid/CHIP insurers, with a maximum cap of 7 calendar days in some cases.

New prohibitions prevent insurers from requiring prior authorization for preventive care, pediatric hospice care, neonatal abstinence syndrome treatment, outpatient substance use disorder services, and blood glucose test strips for diabetes patients.

Clarified that private insurers cannot require prior authorization where it is prohibited by the bill, and added provisions for nonprofit hospitals and self-insured employer plans to comply with specific sections.

Removed the note indicating the bill contains an unfunded mandate, suggesting the fiscal impact assessment may have been updated or the mandate status clarified.

Added new definitions for key terms including 'health carrier' and 'insured', and reorganized the structure of the act to include sections 2-26 in Chapter 687B of NRS.