Oklahoma § 36-6570.56 - Timeframe for validity of prior authorizations for

§ 36-6570.56. Timeframe for validity of prior authorizations for

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.