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.