Colorado Medical Societyhttp://www.cms.org//articles/prior-authorization-of-drugs-jan.-1-2015/
Prior Authorization of Drugs - Jan. 1, 2015Friday, December 12, 2014
CMS-backed legislation to standardize prior authorization of drugs goes into effect Jan. 1, 2015. Click here for a fact sheet and begin learning how to use the new law to the advantage of your patients and practice.
The true administrative simplification of the prior authorization process for prescription drugs will not be realized until health information technology can allow for a completely integrated process for ordering, authorization and dispensing of medications.
Until such technology is available and in use, Colorado’s new law, C.R.S. 10-16-124.5, should be used in obtaining prior approval from carriers for coverage of drug benefits—it is intended to improve the communication surrounding prior authorization by requiring that information on any specific requirements for medications, as well as the process itself, be readily available to the prescribing provider. In addition, timeframes have been established for processing of the authorization. Please reply to CMS (firstname.lastname@example.org) if more information is needed.