If the request to approve a prescription that requires prior authorization is denied or approved other than as requested, the recipient has the right to appeal the decision. The recipient has 30 days from the date of the prior authorization notice to submit the appeal in writing to the address listed on the notice.
If the recipient has been receiving the drug that is being reduced, changed, or denied and an appeal is hand-delivered or postmarked within 10 days of the date of the notice, authorization personnel authorize the prescription for the drug until a decision is made on the appeal.