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- ASP-CAP Amended Prior Authorization ‘Gold Card’ Bill Enacted by Governor
On April 11, House Bill 1271, previously amended by the Arkansas Society of Pathologists (ASP) in collaboration with the CAP and the Arkansas Medical Association, was enacted into law. The CAP partners with state societies to ensure pathologists and clinical laboratories are not subject to denials or reductions to payment because they fail to utilize a laboratory benefit management program or utilized a waiver for prior authorization in the ordering of a laboratory service.
The groups successfully inserted an amendment to the legislation that protects against adverse claims impacts on pathologists and patients. The CAP’s statutory payment safeguard legislative language, as included by the American Medical Association (AMA) in model prior authorization legislation, ensures health carriers cannot deny or reduce payment for health care providers involved in the rendering of a health care service subject to a prior authorization “gold card.”
The legislation establishes a prior authorization “gold card” waiver for providers who have received a 90% or higher approval rate for prior authorization requests for a particular health care service.
The law permits health care providers to obtain “gold cards” beginning on or after January 1, 2024.