• Date Due: November 01, 2026
  • Author: State Corporation Commission
  • Enabling Authority: Chapter 475 Enactment Clause 2. (Regular Session, 2023)
  • Description:
    Annual report on the findings and recommendations of the work group convened to (i) monitor the implementation of electronic prior authorization for medical items and services, pursuant to § 38.2-3407.15:8 of the Code of Virginia, including any relevant federal developments, industry progress and readiness to implement electronic prior authorization for medical items and services, and policies supporting the effective and efficient adoption of electronic prior authorization for medical items and services; (ii) monitor and consider options for revising the prior authorization process for prescription drugs from a less retrospective to a more prospective process; and (iii) consider whether the scope of prior authorization metrics reporting described in § 38.2-3407.15:8 of the Code of Virginia should be expanded to include prescription drugs, recognizing the practical aspects of implementation on a timeline consistent with medical items and services, the uncertainty around the timeline for any federal action and the form any such reporting might take, and the desire to conform any state requirements to those adopted at the federal level. "[Reporting requirements of Chapter 474, Enactment Clause 2., 2023 Acts of Assembly, are identical.]