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Advocacy

ODI and Prior Authorization

posted: February 27, 2019

As a result of legislation passed in 2016 of which OAR supported, Ohio Insurance Law requires insurers and plans defined time limits on which they must respond to prior authorization requests. OAR has been made aware that provisions in the law regarding timelines for approvals are not being met. The OAR government affairs staff contacted the Ohio Department of Insurance to discuss issues regarding prior authorization requests and how to file complaints.

Following from the discussions, OAR has compiled directions on how to file complaints through the ODI and a form that physicians may use when submitting their requests to third party administrators. Additionally, a cover sheet for prior authorization requests has been designed for OAR members’ practices to use when submitting prior authorization requests to pharmacies.

View and Download the Forms