B. The specificity of notices given to providers and members when a prior authorization request has been deferred or denied;

C. Time periods for processing prior authorization requests;

D. The adequacy of the fair hearing process including examining the need for an expedited hearings process to be used in certain circumstances; and

E. The step therapy process, including examining whether exceptions should be made under certain circumstances for frail or other particularly vulnerable members.

3. Quality assurance. The subcommittee shall explore the value of the Department of Human Services' conducting a periodic survey of a representative sample of MaineCare members to examine the experience of members whose request for prior authorization is delayed or denied, including whether or not they experienced adverse health consequences or undesirable side effects or required the use of additional services such as physician, hospital or transportation services as a result of a denial or delay.

4. Drug Utilization Review Committee. The subcommittee shall review any MaineCare Advisory Committee members' concerns about the Drug Utilization Review Committee, including any concerns about the process for public input into the Drug Utilization Review Committee meetings.

5. Rules. The subcommittee shall examine the current practices and policies related to the prior authorization process to determine which, if any, of these the subcommittee would recommend be adopted in the form of rules in accordance with the Maine Revised Statutes, Title 5, chapter 375.

By February 1, 2005, the Department of Human Services shall submit a report to the joint standing committee of the Legislature having jurisdiction over health and human services matters, including the findings and recommendations of the subcommittee and the department's response to each of those recommendations. The joint standing committee may report out legislation to the First Regular Session of the 122nd Legislature related to the use of prior authorization in programs or benefits implemented under the Maine Revised Statutes, Title 22, chapter 101 or 855.