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An Act to Regulate the Prior Authorization Procedure for Treatment of Terminal Illness


Rule 114 was adopted by the Arkansas Department of Insurance to implement portions of the Arkansas Health Care Consumer Act, more specifically, “An Act to Regulate the Prior Authorization Procedure for Treatment of Terminal Illness.” The rule was added to explain that the intent of the Act was not to allow a person to receive an unlimited amount of pain medication without being subject to plan quantity limits or medical safety monitoring. Thus, the rule requires that if a prescription pain medication requires a prior authorization by a carrier or utilization review entity, the prior authorization shall not be denied if the covered person has a terminal illness. However, coverage may be subject to quantity limits and FDA approval and may be monitored by the carrier or utilization review entity to limit drug diversion and abuse. The effective date is Aug. 6, 2016.

Rule 114 »