Common use of Prior Authorization Clause in Contracts

Prior Authorization. Have the ability to require Prior Authorization on medications to ensure appropriate use and to encourage the use of preferred medications. 4.2.21.3.1. The CONTRACTOR must provide a response to requests for Prior Authorization within 24 hours of the request. 4.2.21.3.2. Per 42 U.S.C 1396r 8(d)(5)(B) and 42 CFR 438.3(s)

Prior Authorization. Have the ability to require Prior Authorization on medications to ensure appropriate use and to encourage the use of preferred medications. 4.2.21.3.1. The CONTRACTOR must provide a response to requests for Pharmacy Prior Authorization within 24 hours of the request. 4.2.21.3.2. Per 42 U.S.C 1396r 8(d)(5)(B) and 42 CFR 438.3(s)