IL HB2160

Department of Insurance must develop a uniform electronic prior authorization form for commercial insurers by July 1, 2020, for use in prescription drug coverage requests.

Department of Healthcare and Family Services must develop a uniform electronic prior authorization form for managed care organizations by July 1, 2020, for use in prescription drug coverage requests.

Starting July 1, 2021, all prescribing providers must use the uniform electronic prior authorization form and all insurers and managed care organizations must accept it for prescription drug prior authorization requests.

Prior authorization requests are automatically deemed granted if an insurer or managed care organization fails to respond within 24 hours for urgent medication needs or 72 hours for regular medication needs, or fails to use or accept the uniform electronic form.

Form development must include input from psychiatrists, pharmacists, physicians, family physicians, pediatricians, and insurance industry representatives, and must consider federal Centers for Medicare and Medicaid Services forms and national electronic prior authorization standards.