H-1238

   Amend House File 632 as follows:
   1.  Page 5, after line 31 by inserting: 
   <Sec. ___.  Section 505.26, Code 2015, is amended by adding the following new subsection:
   NEW SUBSECTION.  7.  a.  If a health carrier or pharmacy benefits manager fails to use or accept the prior authorization form that has been approved for use by the health carrier or pharmacy benefits manager pursuant to this section, or to respond to a health care provider’s request for prior authorization of prescription drug benefits within seventy-two hours of the health care provider’s submission of the form, the request for prior authorization shall be considered to be approved.
   b.  However, if the prior authorization request is incomplete or additional information is required, the health carrier or pharmacy benefits manager may request the additional information within the seventy-two-hour period and once the additional information is submitted the provisions of paragraph “a” shall again apply.
   c.  Notwithstanding paragraphs “a” and “b”, the commissioner may develop, by rule, minimum time periods for a health carrier or pharmacy benefits manager to respond to a health care provider’s request for prior authorization of prescription drug benefits or for additional information, that are less than, but in no case exceed seventy-two hours, as the commissioner deems appropriate under the circumstances.>
   2.  By renumbering as necessary.

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L. MILLER of Scott