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    Uniform Prior Authorization

    Issue Description

    Health plans and PBMs administer PA programs using multiple approaches.  These approaches include paper/facsimile processes and, in some cases, web portal processes.  In July 2013, the National Council for Prescription Drug Programs (NCPDP) published the new ePA transaction standards, which will help pave the way for the administration of PA programs through electronic prescribing systems. Read more.


    AMCP Position Statement & Documents

    AMCP supports the role of prior authorization in the provision of quality, cost-effective prescription drug benefits. The fundamental goal of prior authorization is to promote the appropriate and cost-effective use of medications. 

    Pharmacists in all practice settings must work collaboratively to develop specific policies and procedures to ensure that the prior authorization process is administered in the most efficient manner possible, is fully compliant with statutory and regulatory requirements, and provides members, pharmacists, and prescribers with an evidence-based, rational process to promote appropriate drug use. 

    See Also: 




    AMCP Toolkit Resources

     

    Examples of Legislation 

    New Hampshire HB 1608 (2015-2016 legislative session- Enacted) 

    New Hampshire SB 532 (2015-2016 legislative session- Enacted) 

    Ohio SB 129 (2015-2016 legislative session- Enacted) 

      

    Reports/Studies Issued by Public Policy Organizations 

      June 2011 – Health Information and Management Systems—Electronic PA Best Practice Survey Results 

     

     

    Position Statements/Documents of Advocacy and Stakeholder Organizations  

    Sep 2014 – National Council for Prescription Drug Programs (NCPDP)  

    National Council for Prescription Drug Programs: Hot Topics 


    Media Coverage 

     March 2013 – HIT Perspectives: NCPDP’s New Prior Authorization Standard is Nearly Ready for Prime Time Back to Top 

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