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Ark. Code Ann. § 23-99-1111

Requests for prior authorization — Qualified persons authorized to review and approve — Adverse determinations to be made only by Arkansas-licensed physicians

Acts 2015, No. 1106, § 2; 2017, No. 815, § 8.

(1) The initial review of information submitted in support of a request for prior authorization may be conducted by a qualified person employed or contracted by a utilization review entity.

(2) A request for prior authorization may be approved by a qualified person employed or contracted by a utilization review entity.

(3) An adverse determination regarding a request for prior authorization shall be made by a physician who possesses a current and unrestricted license to practice medicine in the State of Arkansas issued by the Arkansas State Medical Board.

(4) A utilization review entity shall provide a method by which a physician may request that a prior authorization request be reviewed by a physician in the same specialty as the physician making the request, by a physician in another appropriate specialty, or by a pharmacologist.

(5) If a request is made under subdivision (c)(2)(A) of this section, the reviewing physician or pharmacologist is not required to meet the requirements of subdivision (c)(1) of this section.

Current official text: Arkansas General Assembly. Digitized from the UniCourt Code Improvement Commission public-domain capture. Reproduced from public-domain Arkansas statutes; confirm against the official source for the current text. Not legal advice.