House File 632 H-1238 Amend House File 632 as follows: 1 1. Page 5, after line 31 by inserting: 2 < Sec. ___. Section 505.26, Code 2015, is amended by 3 adding the following new subsection: 4 NEW SUBSECTION . 7. a. If a health carrier or 5 pharmacy benefits manager fails to use or accept the 6 prior authorization form that has been approved for 7 use by the health carrier or pharmacy benefits manager 8 pursuant to this section, or to respond to a health 9 care provider’s request for prior authorization of 10 prescription drug benefits within seventy-two hours of 11 the health care provider’s submission of the form, the 12 request for prior authorization shall be considered to 13 be approved. 14 b. However, if the prior authorization request is 15 incomplete or additional information is required, the 16 health carrier or pharmacy benefits manager may request 17 the additional information within the seventy-two-hour 18 period and once the additional information is submitted 19 the provisions of paragraph “a” shall again apply. 20 c. Notwithstanding paragraphs “a” and “b” , the 21 commissioner may develop, by rule, minimum time periods 22 for a health carrier or pharmacy benefits manager to 23 respond to a health care provider’s request for prior 24 authorization of prescription drug benefits or for 25 additional information, that are less than, but in no 26 case exceed seventy-two hours, as the commissioner 27 deems appropriate under the circumstances. > 28 2. By renumbering as necessary. 29 ______________________________ L. MILLER of Scott -1- HF632.1516 (2) 86 av/nh 1/ 1 #1. #2.