MEDICAID PRIOR AUTHORIZATION

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that no later than November 1, 2013, the Department of Healthcare and Family Services shall promulgate and file a regulation defining criteria utilized for granting prior authorization for non-preferred medications; criteria utilized for denying a request for prior authorization; criteria utilized for approval or denial of a request for prior authorization made to any managed care entity under contract with the State to administer pharmaceutical drug benefits to any recipient of medical assistance benefits; and other matters. Provides that prior to promulgating this regulation, the Department shall consult with recipients of aid, health care advocates, including mental health care advocates, and providers. Grants the Department the authority to use preemptory rulemaking, in accordance with the Illinois Administrative Procedure Act, to place into the Illinois Administrative Code the criteria, appeal process, and policies set forth. Effective immediately.