Comments on CR 102 (R 2024-03) Prior Authorization Modernization — Coordinated Care Corporation
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A submitted comment letter from Coordinated Care Corporation requesting clarification about how WAC 284-43-2020 applies to prescription drug utilization management timelines under the proposed prior authorization modernization rule.
No material clinical or coverage changes in this revision.
Requested Clarifications and Action Items
Clarify when WAC 284-43-2020 timelines apply to prescription drug UM
Requests clarification from OIC on which prescription drug utilization management scenarios are covered by the timelines in WAC 284-43-2020, noting that WAC 284-43-2025 explicitly addresses prescription drug authorization determination timeframe exceptions and substitution requests and that the applicability of WAC 284-43-2020 to drug UM is unclear.
- Asks OIC to provide additional clarification so insurers, members, and providers can uniformly interpret the timeline requirements under WAC 284-43-2020.
Referenced Regulations
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