SB12-065: Prior Authorization Form for Prescription Drugs

• Commissioner of Insurance must develop a uniform prior authorization form by July 1, 2013, for use by health benefit plans covering prescription drugs.

• Health benefit plans and prescribing providers must use and accept only the uniform form starting January 1, 2014, when requesting prior authorization for prescription drug benefits.

• If a health benefit plan fails to use, accept, or respond to a prior authorization request within 2 business days, the request is automatically deemed granted.

• The uniform form must not exceed 2 pages, be available electronically, and allow prescribing providers to complete and submit it electronically to carriers.

• Approved prior authorizations remain valid for 12 months from the date of approval.