2003 Session

Budget Amendments - HB1400 (Conference Report)

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Prior Authorization Reporting Requirements (language only)

Item 322 #1c

Item 322 #1c

Health And Human Resources
Medical Assistance Services, Department of

Page 307, after line 28, insert:
"J.  The Department of Medical Assistance Services shall monitor the impact of all new prior authorization requirements implemented in the fee-for-service program for Family Access to Medical Insurance Security (FAMIS) and Medicaid services that take effect on or after July 1, 2003.  The Department shall maintain data including the number of service denials, the number of prior authorization requests submitted, the number of requests approved and denied, the number of appeals from prior authorization denials, the outcome of those appeals, and all associated administrative costs.  Such information shall be reported to the Governor and the Chairmen of the House Appropriations and Senate Finance Committees on an annual basis.  The first annual report for fiscal year 2004 shall be submitted no later than 45 days after the end of the fiscal year."

(This amendment requires Department of Medical Assistance Services to maintain and report data necessary to evaluate implementation of the new FAMIS and Medicaid prior authorization requirements.)