(3)__The rules must allow the department to authorize refills of the drug on a case-by-case basis at the end of the 34-day dispensed supply if the prescribing provider has not submitted the required information at that time.

(4) The rules must provide that receipt of a 34-day supply under this subparagraph does not relieve the prescribing provider of the duty to submit all required information and does not entitle the member to receive benefits pending appeal in the event a request for prior authorization is ultimately denied.

C.__The department shall adopt rules to minimize the administrative burdens imposed on prescribing providers.

(1)__The rules must allow a provider to sign a statement on the prior authorization form certifying that the prescribed drug is medically necessary, is supported by the clinical records of the provider and does not exceed the medical needs of the member.__The rules must provide for acceptance of this certification and may not require attachment of clinical records if certification has been completed.__The rules must allow the department's surveillance and utilization review unit to determine, on a case-by-case basis, whether a provider is not subject to this provision.

(2)__The rules must provide for the adoption of a prior authorization form that clearly indicates all of the clinical criteria required for approval of a nonpreferred drug and must solicit the information necessary to determine whether the clinical criteria have been met.

(3)__The rules must prohibit disapproval by the department solely because the department does not have a record in its files of a prior prescription for a nonpreferred drug if a provider certifies that the drug has previously been prescribed for or provided to the member.

(4)__The rules must establish procedures to advise providers of changes in the preferred drug list within 48 hours of the change, by electronic or facsimile notice.