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GA SB416

Bill

Status

Passed

5/2/2012

Primary Sponsor

Earl Carter

Click for details

Origin

Senate

2011-2012 Regular Session

AI Summary

  • Authorizes the Georgia Department of Insurance to develop and adopt exchange standards for electronic prior authorization (e-prior authorization) drug requests between pharmacy benefits managers and health care providers
  • Defines "electronic prior authorization" as requiring a prescriber to obtain electronic approval from a health plan before a specific medication can be dispensed; explicitly excludes facsimiles as a valid electronic submission unless systems are temporarily unavailable
  • Requires the Department of Insurance, within 12 months of the National Council of Prescription Drug Programs (NCPDP) adopting standards, to implement consistent electronic data interchange standards for e-prior authorization requests
  • Mandates that e-prior authorization requests be accessible and submitted through secure electronic transmissions and must support clinical workflow decision support for physician providers
  • Does not require any health care provider to participate in e-prior authorization in order to obtain necessary authorization for patient care

Legislative Description

Insurance, Dept. of; authorize to develop exchange standards regarding electronic prior authorization drug requests with health care providers

Last Action

Effective Date

7/1/2012

Committee Referrals

Insurance3/7/2012
Health and Human Services2/15/2012

Full Bill Text

No bill text available