§36-6570.56. Timeframe for validity of prior authorizations for
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chronic conditions.
A. If a prior authorization is required for a prescription drug for the treatment of a chronic condition of an enrollee, and the enrollee remains on the same health plan, then the prior authorization shall remain valid for three
(3)years from the date the health care provider receives the prior authorization approval, unless clinical criteria changes, the enrollee's health plan removes the generic prescription drug from the formulary, or moves the prescription drug to a less preferred tier status on its formulary.
B. This section shall not apply to prior authorizations approved for:
1. A prescription drug that is an opioid or is a controlled substance that is prohibited from being dispensed without a prescription under the Federal Food, Drug, and Cosmetic Act, 21 U.S.C., Section 301 et seq., as amended; or
2. A prescription drug for the treatment of weight loss.
C. Provided the provisions of this section do not violate any applicable law, regulation, or the Oklahoma Medicaid State Plan. Added by Laws 2025, c. 447, § 8, eff. Nov. 1, 2025.