235.038 Standardized Electronic Prior Authorization Transactions

235.038

235.038 Standardized Electronic Prior Authorization Transactions: The Texas Medical Association supports policy and legislation that third-party payers, benefit managers, and any other party conducting utilization management be required to accept and respond to (1) standard electronic prior authorization (ePA) transactions for pharmacy benefits that use a nationally recognized format, such as the National Council for Prescription Drug Programs (NCPDP) SCRIPT Standard; and (2) standard electronic transactions for review and response to prior authorization requests for medical service benefits that use a nationally recognized format, such as  the ASC X12N 278 Health Care Service Review Request. (CSE Report 3-A-18)

Last Updated On

August 14, 2018