West Virginia HB4984 modifies prior authorization requirements for FDA-approved antipsychotics in Medicaid.

West Virginia HB4984 revises the prior authorization process for FDA-approved antipsychotics under Medicaid. The Bureau for Medical Services must use an electronic portal for prior authorization submissions, with instructions and the portal's address on the insured's insurance card. The Bureau must respond to requests within five business days, or two days for urgent cases. The bill mandates a peer-to-peer appeal process for rejected authorizations, with decisions within five business days. Approved authorizations are valid for six months.

West Virginia HB4984 modifies prior authorization requirements for FDA-approved antipsychotics in Medicaid.

West Virginia HB4984 revises the prior authorization process for FDA-approved antipsychotics under Medicaid. The Bureau for Medical Services must use an electronic portal for prior authorization submissions, with instructions and the portal's address on the insured's insurance card. The Bureau must respond to requests within five business days, or two days for urgent cases. The bill mandates a peer-to-peer appeal process for rejected authorizations, with decisions within five business days. Approved authorizations are valid for six months.