In an effort to reduce the number of different prior authorization forms with which providers must contend, the Texas Department of Insurance (TDI) has adopted a single, standard form for requesting prior authorization of health care services beginning September 1, 2015. On December 12, 2014, TDI published the form along with the rule that requires all health benefit plan issuers, and their agents and administrators, to accept and use this form when submitted by a provider to request prior authorization of a health care service. TDI anticipates that the use of a single form by all health plan issuers, including Medicaid and CHIP, will lower provider administrative costs and provide patients greater access to necessary care. Health plan issuers are required to have this form available in paper as well as on their websites. The new form is not for use for requesting prior authorization of a prescription drug. TDI is currently developing a separate standard form for that purpose. TDI is required by statute to develop standardized forms for prior authorization of both health care services and prescription drugs. The agency has been working with an advisory committee to develop the contents and format of the forms. The link to the standard health benefits prior authorization form is available here and the rule is available here.

Reporter, Kathy Poppitt, Austin, +1 512 457 2004, kpoppitt@kslaw.com.