New Approval Time Frames for Prescription Drug Prior Authorizations January 13, 2016 News, Practice Management Department of Insurance, preauthorization, prescription drugs 0 A new law took effect January 1, 2016, that requires health plans and health insurers to respond to prescription drug prior authorization requests within 72 hours for non-urgent requests and 24 for urgent requests. SB 282 deems such requests to be granted if the payor fails to respond within these time frames. SB 282 also requires the Department of Managed Health Care and the Department of Insurance to create a standard electronic prior authorization request form no later than January 1, 2017. Prescribers and payors will be required to use and accept this uniform electronic prior authorization form beginning July 1, 2017, or 6 months after the form is developed, whichever is later. A second and related law (AB 374) requires that prior authorization for prescription drug step therapy override requests be submitted in the same manner—and using the same electronic form, when available—as a prescription drug prior authorization requests. Plans and insurer must also respond to such requests within the time frames set forth in SB 282. Click here for more information on SB 282. Comments are closed.
