ARSD 67:16:14:24. Appeal process

If the department denies the prior authorization request, the medical professional may appeal the decision. At the time of the denial, the department shall advise the medical professional of the procedures to follow to appeal the denial and that the appeal must be made within 24 hours following the denial The medical professional will receive a final decision within 24 hours after the additional information is received. If the request is approved, the pharmacist may fill the prescription as written. If the original decision to deny the claim is confirmed, the medical professional will be notified.