OK SPA 24-0011 & APA WF # 24-15 Third Party Liability (TPL) Prior Authorization
In accordance with Section 202 of the Consolidated Appropriations Act, a state plan is required to attest that there is state legislation forbidding third party insurers from denying a claim solely based on the Medicaid member’s failure to obtain a prior authorization for a service, so long as that service is covered under the state plan or a waiver. Administrative rules are also being amended to align with these new prior authorization requirements.
Please view the draft SPA here: OK SPA #24-0011 and the circulation document here: APA WF # 24-15 and submit feedback via the comment box.
Circulation Date: 04/19/2024
Tribal Consultation: 04/30/2024
Comment Due Date: 05/19/2024
SPA Effective Date: 06/01/2024, Contingent Upon CMS Approval;
Rules Effective Date: 07/01/2024 or Immediately Upon Governor’s Approval, whichever is later
Submit a Comment
After you submit your comment, you should be re-directed to a confirmation page. If you are not, please submit your comment through e-mail to federal.authorities@okhca.org.
Please note that all comments must be reviewed and approved prior to posting. Approved comments will be posted Monday through Friday between the hours of 7:30 a.m. – 4 p.m. Any comments received after 4 p.m. will be posted on the following business day.
Comments
No comments.
