Prior Authorization in Missouri
Missouri enacted SB 100 (2021) establishing step therapy exception requirements. The law requires insurers to grant exceptions when the required step is contraindicated, was tried and failed, or is expected to be ineffective. Missouri mandates PA decisions within specified timeframes.
Key Facts About PA in Missouri
- ✓ Step therapy exception requirements codified in law
- ✓ PA decisions must be made within reasonable timeframes
- ✓ External review available through the Missouri Department of Commerce and Insurance
- ✓ Anthem BCBS and Blue Cross Blue Shield of Kansas City are major carriers
Quick Stats
- Typical Appeal Filing Window: 30 days
- External Review Available: Yes
- Major Payers: 4
Top Payers in Missouri
RxCheckUp generates payer-specific Letters of Medical Necessity for each of these Missouri carriers:
Anthem BCBS MissouriBlue Cross Blue Shield of Kansas CityUnitedHealthcareCigna