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Prior Authorization Law Now In Effect

Posted By Jim Broyles, PhD, OPA Director of Professional Affairs, Thursday, January 11, 2018

As many of you may remember, the “Prior Authorization Law,” which was passed in 2016, will begin its impact this year. The Ohio Psychological Association’s Advocacy Team worked very hard to contribute to the passage of this law (it was a featured priority for past OPA Legislative Days), and we should now see the benefits of its requirements.

Among other things, the law states:

For health insurance policies issued on or after January 1, 2018, the insurance company must: 

  • Make preauthorization forms available electronically
  • Allow preauthorization forms to be submitted electronically
  • Respond to requests for authorization within
    • 48 hours for urgent situations
    • 10 days for nonurgent situations
  • List preauthorization requirements on the company’s website 
  • Provide a streamlined appeal process including reasonable timelines for denied authorizations
  • Prohibit retroactive denial of authorizations granted

In the past, I have provided support for a number of psychologists who were requesting help with obtaining preauthorization for testing or for an extended therapy session time. This law would affect the processes involved here, requiring them to be clear and accountable. 

Please feel free to give me feedback about what you are encountering as you interact with insurance companies. Are you finding these features available from insurance companies on their websites?  Are you aware of law violations?  

I welcome your questions as well as your feedback.

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