The 2023 Session of the Virginia General Assembly, in SB 1261 and HB1471, re-enacted amended provisions first adopted in 2022 designed to automate the prior authorization process for prescription drugs and provide patient-specific real time prescription benefit (RTPB) information to enrollees and contracted providers for covered prescription drugs, beginning July 1, 2025. These amendments have been codified in Code of Virginia §§38.2-3407.15:2 and 38.2-3407.15:7.
The final sentence of § 38.2-3407.15:2 (B)(17) states:” A provider may request a waiver of compliance under this subdivision for undue hardship for a period specified by the appropriate regulatory authority with the Health and Human Resources Secretariat.”
The Department of Health Professions (DHP) has been designated as the appropriate regulatory agency by the Secretary of Health and Human Resources to receive and review requests for a waiver of compliance from 38.2-3407.15.2 (B)(17) by health care practitioners/providers regulated by a DHP Board, including affiliated providers’ offices.
If you would like to request such a waiver of compliance, please complete the form at the link below and provide it via email or regular mail to DHP, as directed at the bottom of the form.
The waiver form will remain effective until July 1, 2027. No further action is required on your behalf.
Download the Electronic Prior Authorization Hardship Waiver form.