OH SB129

Establishes prior authorization requirements for health insurers, requiring electronic submission through secure systems using NCPDP SCRIPT standards for prescription drugs and council for affordable quality health care standards for medical benefits by January 1, 2018.

Mandates insurers respond to prior authorization requests within 48 hours for urgent care services or 10 calendar days for routine requests, and prohibits retroactive denials of previously approved authorizations except in cases of fraud.

Provides 12-month prior authorization approval periods for drugs treating chronic conditions (conditions lasting longer than six continuous months) unless exceptions apply, with specified exceptions for controlled substances, opioids, and benzodiazepines.

Requires recovery housing for opioid and drug addiction treatment to have administrative protocols and quality standards, permit medication-assisted treatment, and determine resident stay duration based on individual needs rather than arbitrary time limits.

Delays effective date of certain community mental health and addiction services laws from September 15, 2016 to July 1, 2017, and applies parallel prior authorization requirements to sickness and accident insurers and Medicaid programs.