{"id":24338,"date":"2025-09-04T12:35:40","date_gmt":"2025-09-04T16:35:40","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/?page_id=24338"},"modified":"2026-03-23T15:10:37","modified_gmt":"2026-03-23T19:10:37","slug":"electronic-prior-authorization-real-time-patient-specific-benefit-waiver-requests","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/licensure-and-certification\/electronic-prior-authorization-real-time-patient-specific-benefit-waiver-requests\/","title":{"rendered":"Electronic Prior Authorization \/ Real-Time Patient Specific Benefit Waiver Requests"},"content":{"rendered":"<ul>\n<li><a href=\"https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/96\/Electronic-Prior-Authorization.pdf\" target=\"_blank\" rel=\"noopener\">Electronic Prior Authorization<\/a> (pdf)<\/li>\n<\/ul>\n<p>Code of Virginia sec. 38.2-3407.15:2(B)(17) requires health care providers to ensure electronic prescribing systems and electronic health record systems which they own or for which they contract have the ability to access \u2013 at the time a prescription is written \u2013 the electronic prior-authorization process for the insurance carrier and \u201creal-time patient-specific benefit information, including out-of-pocket costs and more affordable medication alternatives.\u201d The statute further provides that a provider may request a waiver \u201cfor undue hardship\u2026.\u201d<\/p>\n<p>The Office of the Secretary of Health and Human Resources has designated the Virginia Department of Health, Office of Licensure and Regulation as the appropriate regulatory authority to receive and review such requests from health care facilities. Health care providers and practitioners should submit a request to the Virginia Department of Health Professions, which has been designated by OSHHR to receive\/review waiver requests from those individuals.<\/p>\n<p>Please email the completed form or any questions to the OLC\u2019s Senior Policy Analyst at <a href=\"mailto:geoff.garner@vdh.virginia.gov\">geoff.garner@vdh.virginia.gov<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Electronic Prior Authorization (pdf) Code of Virginia sec. 38.2-3407.15:2(B)(17) requires health care providers to ensure electronic prescribing systems and electronic health record systems which they own or for which they contract have the ability to access \u2013 at the time a prescription is written \u2013 the electronic prior-authorization process for the insurance carrier and \u201creal-time [&hellip;]<\/p>\n","protected":false},"author":52,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"tags":[],"class_list":["post-24338","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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