Legal Landscape of Electronic Prior Authorization (ePA) and Its Effect on Patients and Prescribers

by Instructor: Jordan Hilsher, CAHIMS; Instructor: Kim Diehl-Boyd, NSC; Instructor: Ryan Druseikis, BS; Instructor: Ryan Tarzy, BA
Credentialed for: Medication Aide

$20.00

i 1.00 CEH

Course Overview

The goal of this presentation is to discuss ePA mandates, points of access to ePA, the role of plans, and the effect of ePA solutions on patient care and outcomes. Upon completion of the webinar, participants will be able to explain the electronic prescription drug prior authorization process and recall named standards, identify states that have legislation surrounding electronic submission of PA requests, describe requirements of various PA legislation, identify access points to ePA solutions and the effect of ePA legislation on prior authorization process, discuss the current state of ePA availability and adoption re: different factors, and explain prior authorization workflow to patients/caregivers.

About the Course Author

Jordan Hilsher, CAHIMS, generates leads through a blend of techniques, including leveraging relationships with existing clients, prospecting fresh leads, and following up on inbound leads. He generates client interest in Incubation Studio pilots (or refers clients to mature CoverMyMeds solutions). He manages the discovery process for new opportunities, using a consultative sales approach to determine requirements and expectations of a variety of client stakeholders, including business development, engineering, and C-level executives. He collaborates with others in the Incubation Studio to execute on pilots, including overseeing implementations. Jordan presents at user conferences and travels to clients as needed. Jordan Hilsher, CAHIMS has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Kim Diehl-Boyd, NSC, Director, Industry Relations & Government Affairs, leads state and federal government affairs initiatives proposing positive change, and she helps guide policy. Her efforts have contributed to the passage of legislation and regulation to include Electronic Data Interchange (EDI) state reporting, electronic prior authorization, and electronic billing and reimbursement. She coordinates engagement and participation in standards development and enhancement at National Council for Prescription Drug Programs (NCPDP) task group and work groups. She focuses on e-prescribing and prior authorization, specialty pharmacy services and data exchange, long-term care, Medicare, and state prescription drug monitoring program (PDMP) models. She holds paralegal certification from the U.S. Air Force and SCRIPT certification from the National Council for Prescription Drug Programs (NCPDP) in February 2017. She has several most valuable player (MVP) awards for her contributions in work groups, committees, and task groups at NCPDP. Kim Diehl-Boyd, NSC has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Ryan Druseikis, Marketing Coordinator for CoverMyMeds, leads execution on strategic efforts, identifies new opportunities to engage with target audiences, leverages social media as a tool for networking, provides status reports on all marketing initiatives, and participates in strategic discussions with internal stakeholders. Ryan Druseikis, BS has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Ryan Tarzy, Director, Incubation Studio, CoverMyMeds, leads business development at CoverMyMeds, including closing sales, forming strategic partnerships, and strengthening existing partnerships. He has more than 15 years of experience as founder or executive of digital health startups. He served as SVP of business development for PokitDok and VP of business development at Healthline Networks. He was a co-founder of MediKeeper, one of the early pioneers in digital health. He was also co-founder of Playful Bee, an early childhood development startup with the mission of delivering children to kindergarten healthy and prepared for school. He is a subject matter expert within health technology, health gaming, and personal health records arenas. Ryan Tarzy, BA has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
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Detailed Transcripts

License Tracking/Reminders

Accreditation Information

Certificates provided by accrediting body (8 Match)

  • American Nurses Credentialing Center

    1.00HOURS

    In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


  • California Board of Registered Nursing

    1.00HOURS

    Provider approved by the California Board of Registered Nursing, CEP# 13791 Nurses will receive 1.0 contact hours for participating in this course.
  • District of Columbia Board of Nursing

    1.00HOURS

    District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290). Nurses will receive 1.0 contact hours for participating in this course.
  • Florida Board of Nursing

    1.00HOURS

    Florida Board of Nursing CE Provider #: 50-290 Nurses will receive 1.0 contact hours for participating in this course.
  • Georgia Board of Nursing

    1.00HOURS

    Georgia Board of Nursing CE Provider #: 50-290 Nurses will receive 1.0 contact hours for participating in this course.
  • Accreditation Council for Continuing Medical Education

    1.00HOURS

    In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


    Relias LLC designates this enduring activity for a maximum of 1.0 AMA PRA category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
  • South Carolina Board of Nursing

    1.00HOURS

    This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-713080
  • West Virginia Board of Registered Nursing

    1.00HOURS

    West Virginia Board of Registered Nursing (CEBroker Provider #50-290)
    Nurses will receive 1.0 contact hours for participating in this course.


Course Details
  • Course Code:

    REL-ACU-0-WEB334
  • Hours:

    1.00
  • Type:

    Online Course
  • Release Date:

    2019-05-01
  • Expiration Date:

    2020-10-06
  • Learning Objectives:

    Describe requirements of various PA-related legislation; Discuss the current state of ePA availability and adoption; Explain the ePA process and recall named standards for prescription medications; Explain the workflow to patients/caregivers; Identify access points to ePA solutions and the effect of ePA legislation on the PA process; Identify states that have legislation surrounding electronic submission of prior authorization (PA) requests
  • Target Audience:

    The target audience for this course is: Nurses; Physicians; in the following settings: Acute Care Facility.
  • Course Delivery Method and Format:

    Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
    Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
    If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
    All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
    Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
    All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
    To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
  • Accommodations:

    If you require special accommodations to complete this module, please contact Relias Customer Support here.
  • Disclosures:

    Expert Reviewers, Instructors, and Staff Writers disclosures will be listed above after the individuals' biographical paragraph. All other members involved within the planning of this educational activity have declared no conflict of interest exists when planning and developing this course.
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