New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 24A - HEALTH CARE QUALITY ACT APPLICATION TO INSURANCE COMPANIES, HEALTH SERVICE CORPORATIONS, HOSPITAL SERVICE CORPORATIONS, AND MEDICAL SERVICE CORPORATIONS
Subchapter 3 - UTILIZATION MANAGEMENT
Section 11:24A-3.7 - Carrier action on the IURO decisions
Universal Citation: NJ Admin Code 11:24A-3.7
Current through Register Vol. 56, No. 24, December 18, 2024
(a) A carrier shall provide benefits (including authorization of a service or supply and payment of the claim) pursuant to the IURO's determination and comply with the IURO's determination without delay, but no later than 10 business days from receipt of the IURO's determination, regardless of whether the carrier intends to seek judicial review of the external review decision, unless there is a judicial decision stating otherwise.
1. The carrier
shall provide benefits to comply with the IURO decision sooner if the medical
exigencies of the case warrant a more rapid response.
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