# D.C. Code § 31-3875.04: Length of prior authorization

> District of Columbia · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.04

## Section

- **Citation:** D.C. Code § 31-3875.04
- **Heading:** Length of prior authorization
- **Jurisdiction:** District of Columbia
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** DC Code / Title 31 / Chapter 38F / § 31-3875.04

## Text

(a) Except as otherwise provided in subsection (b) of this section, approval shall be valid for at least one year from the date the enrollee receives notice of the approval and shall remain valid regardless of any changes in dosage for a prescription drug prescribed by the health care provider; provided, that the utilization review entity may rescind the approval for dosages exceeding limitations set by federal or District laws or regulations.
(b) (1) Approval for a course of treatment, as that term is defined at 2 CFR 422.112(b)(8)(ii)(A), or for a health care service to treat a chronic condition, shall remain valid for as long as medically reasonable and necessary to avoid disruptions in care, in accordance with applicable coverage criteria, the enrollee's medical history, and the treating provider's recommendation.
(2) Not Funded.
(c) A utilization review entity may not revoke, limit, condition, or restrict approval if care is provided within 45 business days from the date the enrollee receives notice of the approval; provided, that approval may be revoked or otherwise restricted in cases of fraud.

## Nearby sections

- [D.C. Code § 31-3875.01 § 31-3875.01. Definitions.](https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.01.md)
- [D.C. Code § 31-3875.02 § 31-3875.02. Prior authorization requirements and restrictions.](https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.02.md)
- [D.C. Code § 31-3875.03 § 31-3875.03. Prior authorization in non-urgent, urgent, and emergency circumstances.](https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.03.md)
- [D.C. Code § 31-3875.04 § 31-3875.04. Length of prior authorization.](https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.04.md)
- [D.C. Code § 31-3875.05 § 31-3875.05. Appeals.](https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.05.md)
- [D.C. Code § 31-3875.06 § 31-3875.06. Review personnel qualifications.](https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.06.md)
- [D.C. Code § 31-3875.07 § 31-3875.07. Continuity of care for enrollees.](https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.07.md)
- [D.C. Code § 31-3875.08 § 31-3875.08. Failure to comply and penalties.](https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.08.md)
- [D.C. Code § 31-3875.09 § 31-3875.09. Data transparency.](https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.09.md)
- [D.C. Code § 31-3875.10 § 31-3875.10. Rulemaking.](https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.10.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_DC_T31_C38F_S31-3875.04. Check the current official text before relying on it. Not legal advice.