DHS 107.02(3)(b)4.4. To determine if less expensive alternative care, services or supplies are usable; DHS 107.02(3)(b)5.5. To promote the most effective and appropriate use of available services and facilities; and DHS 107.02(3)(c)(c) Penalty for non-compliance. If prior authorization is not requested and obtained before a service requiring prior authorization is provided, reimbursement shall not be made except in extraordinary circumstances such as emergency cases where the department has given verbal authorization for a service. DHS 107.02(3)(d)(d) Required information. A request for prior authorization submitted to the department or its fiscal agent shall, unless otherwise specified in chs. DHS 101 to 108, identify at a minimum: DHS 107.02(3)(d)1.1. The name, address and MA number of the recipient for whom the service or item is requested; DHS 107.02(3)(d)2.2. The name and provider number of the provider who will perform the service requested; DHS 107.02(3)(d)4.4. The attending physician’s or dentist’s diagnosis including, where applicable, the degree of impairment; DHS 107.02(3)(d)5.5. A description of the service being requested, including the procedure code, the amount of time involved, and dollar amount where appropriate; and DHS 107.02(3)(e)(e) Departmental review criteria. In determining whether to approve or disapprove a request for prior authorization, the department shall consider: DHS 107.02(3)(e)6.6. The extent to which less expensive alternative services are available; DHS 107.02(3)(e)9.9. The limitations imposed by pertinent federal or state statutes, rules, regulations or interpretations, including medicare, or private insurance guidelines; DHS 107.02(3)(e)10.10. The need to ensure that there is closer professional scrutiny for care which is of unacceptable quality; DHS 107.02(3)(e)11.11. The flagrant or continuing disregard of established state and federal policies, standards, fees or procedures; and DHS 107.02(3)(e)12.12. The professional acceptability of unproven or experimental care, as determined by consultants to the department. DHS 107.02(3)(f)(f) Professional consultants. The department or its fiscal agent may use the services of qualified professional consultants in determining whether requests for prior authorization meet the criteria in par. (e). DHS 107.02(3)(g)(g) Authorization not transferable. Prior authorization, once granted, may not be transferred to another recipient or to another provider. In certain cases the department may allow multiple services to be divided among non-billing providers certified under one billing provider. For example, prior authorization for 15 visits for occupational therapy may be performed by more than one therapist working for the billing provider for whom prior authorization was granted. In emergency circumstances the service may be provided by a different provider.