(a) The initial review of information submitted in support of a request for prior authorization may be conducted by a qualified person employed or contracted by a utilization review entity.
(b) A request for prior authorization may be approved by a qualified person employed or contracted by a utilization review entity.
(c)
(1) An adverse determination regarding a request for prior authorization shall be made by a physician who possesses a current and unrestricted license to practice medicine in the State of Arkansas issued by the Arkansas State Medical Board.
(2)
(A) A utilization review entity shall provide a method by which a physician may request that a prior authorization request be reviewed by a physician in the same specialty as the physician making the request, by a physician in another appropriate specialty, or by a pharmacologist.
(B) If a request is made under subdivision (c)(2)(A) of this section, the reviewing physician or pharmacologist is not required to meet the requirements of subdivision (c)(1) of this section.
Structure Arkansas Code
Title 23 - Public Utilities and Regulated Industries
Chapter 99 - Healthcare Providers
Subchapter 11 - Prior Authorization Transparency Act
§ 23-99-1102. Legislative findings and intent
§ 23-99-1104. Disclosure required
§ 23-99-1105. Prior authorization — Nonurgent healthcare service
§ 23-99-1106. Prior authorization — Urgent healthcare service
§ 23-99-1107. Prior authorization — Emergency healthcare service
§ 23-99-1110. Waiver prohibited
§ 23-99-1112. Application of subchapter
§ 23-99-1113. Benefit inquiries authorized
§ 23-99-1114. Limitations on step therapy — Definition
§ 23-99-1116. Failure to comply with subchapter — Requested healthcare services deemed approved
§ 23-99-1117. Standardized form required for prescription drug benefits
§ 23-99-1119. Medication-assisted treatment for opioid addiction