CT SB00034

Health carriers must issue electronic authorization to pharmacies for temporary supplies of chronic disease drugs (non-controlled substances) prescribed by specialist providers during prospective review grievances, with confirmation of payment availability.

Health carriers must confirm with the prescribing provider within 24 hours of issuing pharmacy authorization whether the provider concurs with dispensing the temporary drug supply, and must cancel authorization if provider does not concur.

Reduces urgent care adverse determination review timeframe from 72 hours to 48 hours for most cases, and maintains 24-hour timeframe for specified urgent health care services or treatments.

Reduces expedited external review timeframe from 72 hours to 48 hours for most cases, and maintains 24-hour timeframe for specified urgent health care services or treatments.

Exemption from temporary drug supply provisions does not apply to generic or brand name drug substitutions unless the prescribing provider specified no substitution for the prescribed brand name drug.