AZ SB1361

Health care insurers providing prescription drug benefits must use a standardized prior authorization process established by the Department of Insurance director by July 1, 2015, beginning January 1, 2016.

The director must prescribe a single standard form for prior authorization requests, require insurers to post their prior authorization requirements and drug lists on their websites, and allow electronic submission of requests.

Prior authorization requests are deemed granted if insurers fail to respond within required timeframes: 2 business days for electronically submitted requests, 3 business days for fax or email submissions, and 1 day for urgent requests.

A committee consisting of insurance representatives, health care professionals, pharmacists, patients, and public members was established to recommend a standard uniform prior authorization form and electronic submission process by January 1, 2015.

Arizona Health Care Cost Containment System contractors must develop an electronic prior authorization process for prescription drug benefits by October 1, 2016, allowing licensed prescribers to submit requests electronically and receive electronic approval or denial responses.