Bill Text: AZ SB1385 | 2012 | Fiftieth Legislature 2nd Regular | Introduced
Bill Title: Prior authorization; prescription drugs; form
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2012-01-31 - Referred to Senate BI Committee [SB1385 Detail]
Download: Arizona-2012-SB1385-Introduced.html
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REFERENCE TITLE: prior authorization; prescription drugs; form |
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State of Arizona Senate Fiftieth Legislature Second Regular Session 2012
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SB 1385 |
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Introduced by Senators Reagan, Murphy; Representative Heinz: Senators Cajero Bedford, Lopez
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AN ACT
Amending title 20, chapter 1, Arizona Revised Statutes, by adding article 5; Amending title 32, chapter 32, article 1, Arizona Revised Statutes, by adding section 32-3215; relating to prior authorization.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 1, Arizona Revised Statutes, is amended by adding article 5, to read:
ARTICLE 5. PRIOR AUTHORIZATION
20-195. Prior authorization form; prescription drugs; health care insurers; health care professionals; definitions
A. Beginning January 1, 2014, any health care insurer that provides prescription drug benefits shall use and accept only the prior authorization form developed pursuant to section 20-196 when requiring prior authorization for prescription drug benefits.
B. If any health care insurer fails to use or accept a prior authorization form or fails to respond within five business days after receiving a completed prior authorization request form from a health care professional who is licensed or certified under title 32 and who is authorized to prescribe prescription drugs, the prior authorization request shall be deemed to have been granted.
C. An authorized agent of a health care professional who is licensed or certified under title 32 and who is authorized to prescribe prescription drugs may initiate the prior authorization request with a health care insurer and confer and consult on behalf of the health care provider with a health care insurer regarding a prior authorization request.
D. For the purposes of this section:
1. "Authorized agent of a health care professional" means:
(a) An employee of the health care professional.
(b) A contract employee of the health care professional.
(c) A pharmacist who is authorized by the health care professional to confer or consult with an insurer regarding prescriptions initiated by the prescriber.
2. "Health care insurer" means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital and medical service corporation.
20-196. Uniform prior authorization form for prescription drugs committee; membership; duties
A. The uniform prior authorization form for prescription drugs committee is established in the department consisting of the following members:
1. The director or the director's designee.
2. Three members who are representatives of different health care insurers as defined in section 20‑195 and who are appointed by the director.
3. Three members who are health care professionals licensed or certified under title 32, who are authorized to prescribe prescription drugs and who are appointed by the director.
4. One member who is A pharmacist licensed under title 32 and who is appointed by the director.
5. One member of the public who is appointed by the director.
B. Committee members shall serve at the pleasure of the director and are not eligible to receive compensation or reimbursement for expenses.
C. On or before September 1, 2013, the committee shall develop a uniform prior authorization form for prescription drugs to simplify the prior authorization process. The prior authorization form shall be no more than two pages in length and shall be designed to permit its use as a written document and to be electronically available and transmissible.
D. After the initial uniform prior authorization form for prescription drugs is developed and in use, the director, as needed, may reconvene the committee to consider whether changes are necessary to the uniform prior authorization form. If the committee determines that changes are necessary, the director may prescribe a revised uniform prior authorization form. All health care insurers and health care professionals who are licensed or certified under title 32 and who are authorized to prescribe prescription drugs or authorized agents of health care professionals are required to use the revised form beginning one hundred eighty days from the date the director prescribes the revised form.
Sec. 2. Title 32, chapter 32, article 1, Arizona Revised Statutes, is amended by adding section 32-3215, to read:
32-3215. Prior authorization for prescription drugs; use of standard form; definitions
A. Beginning January 1, 2014, a health care professional who is licensed or certified under this title and who is authorized to prescribe prescription drugs or the authorized agent of the health care professional shall use only the prior authorization form developed pursuant to section 20‑196 when requesting from a health care insurer prior authorization for prescription drug benefits on behalf of a patient.
B. An authorized agent of a health care professional who is licensed or certified under this title and who is authorized to prescribe prescription drugs may initiate the prior authorization request with a health care insurer and confer and consult on behalf of the health care provider with a health care insurer regarding a prior authorization request.
C. For the purposes of this section:
1. "Authorized agent of a health care professional" means:
(a) An employee of the health care professional.
(b) A contract employee of the health care professional.
(c) A pharmacist who is authorized by the health care professional to confer or consult with an insurer regarding prescriptions initiated by the prescriber.
2. "Health care insurer" means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital and medical service corporation.
