054.00.16 Ark. Code R. § 001 - Rule 114: Prior Authorizations for Pain Medications for Terminal Illnesses
This Rule is issued pursuant to Ark. Code Ann. § 23-99^14 which authorizes the Arkansas Insurance Commissioner ("Commissioner") to promulgate rules necessary to carry out the "Arkansas Health Care Consumer Act" subchapter, Act 992 of 2015, "An Act to Regulate the Prior Authorization Procedure for Treatment of a Terminal Illness," adds various provisions to the prior authorization section in the "Arkansas Health Care Consumer Act" pertaining to prescription pain medication for persons with terminal illnesses. This Rule is also issued pursuant to Ark. Code Ann. § 23-61-108(a)(1) and (b)(1). The requirements in Act 992 of 2015 were not later codified in the Prior Authorization subchapter in Act 1106 of 2015, the "Prior Authorization Transparency Act." The Arkansas Insurance Department ("Department") however interprets the provisions in Act 992 of 2015 to be enforceable and valid as enacted. The Department is also promulgating the requirements in Act 992 of 2015 to clarify their application to health benefit plans as defined in this Rule, subject to requirements of this Rule.
If a prescription pain medication requires a prior authorization
by a healthcare
The effective date of this Rule shall be June 27, 2016.
SUMMARY
AID PROPOSED RULE 114: PRIOR AUTHORIZATIONS FOR PAIN MEDICATIONS FOR TERMINAL ILLNESSES
* The proposed rule is needed to clarify Act 992 of 2015, "An Act to Regulate the Prior Authorization Procedure for Treatment of a Terminal Illness." The rule is needed to explain that the intent of the Act above was not to permit a person to receive an unlimited amount of pain medication in prescription coverage for persons with terminal illnesses without being subject to plan quantity limits or medical safety monitoring.
* The sponsor agreed to this restriction however an amendment was not allowed to timely be added before expiration of the last regular legislative session, and the objective was that the Insurance Department could promulgate a rule describing this restriction as outlined in Section Three (3) of the proposed rule.
* An
Notes
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