{"data":{"id":"us-ga/o.c.g.a.-33-46-23.1","jurisdiction":"us-ga","citation":"O.C.G.A. § 33-46-23.1","heading":"[Effective January 1, 2023] Prior authorization of prescription medications for chronic conditions.","body":"(a) As used in this Code section, the term:\n(1) “Chronic condition” means a serious, long-term, physical, mental, or developmental disability or disease.\n(2) “Ongoing medication therapy” means a clinical and evidence-based treatment that uses a prescribed medicine to prevent, diagnose, treat, or relieve the symptoms of a chronic condition and is continuing or expected to continue for at least a year.\n(b) Unless otherwise provided in subsection (c) of this Code section or prohibited by state or federal law, if a healthcare provider receives a prior authorization for a medication prescribed to a covered person with a chronic condition that requires ongoing medication therapy, and the provider continues to prescribe the medication, and the medication is used for a condition that is within the scope of use approved by the United States Food and Drug Administration or has been proven to be a safe and effective form of treatment for the patient’s specific underlying condition based on clinical practice guidelines that are developed from peer-reviewed publications, the prior authorization received shall:\n(1) Be valid for the lesser of:\n(A) One year from the date the healthcare provider receives the prior authorization; or\n(B) Until the last day of coverage under the covered person’s healthcare plan; and\n(2) Cover any change in dosage prescribed by the healthcare provider during the period of authorization.\n(c) (1) This Code section shall not apply to:\n(A) Medications that are prescribed for a nonmaintenance condition;\n(B) Medications that have a typical treatment period of less than 12 months;\n(C) Medications for which medical or scientific evidence does not support a 12 month approval, including medications where an initial shorter duration approval is necessary to demonstrate appropriate response to therapy; or\n(D) Medications that are opioid analgesics or benzodiazepines.\n(2) Nothing in this Code section prevents the prior authorization of a medication for more than a year if permissible by the covered person’s healthcare plan.","path":["TITLE 33 Insurance","CHAPTER 46 Certification of Private Review Agents","Article 2 Prior Authorizations"],"source_url":"https://archive.org/download/gov.ga.ocga.2018/release86.2022.11/gov.ga.ocga.title.33.odt","current_through":"Release 86 (2022-11)","vintage":"Public.Resource.Org bulk O.C.G.A., Release 86 (2022-11), retrieved 2026-09-17","retrieved_at":"2026-09-17T19:34:57Z","sha256":"36aaec7dd7d93a1b38549811be7069d7260463342a2694396423af87ed094246","source_id":"us-ga","stale":false,"prev":"us-ga/o.c.g.a.-33-46-23","next":"us-ga/o.c.g.a.-33-46-24"},"notice":"GroundRules: Original legal text. Not legal advice."}