; and (II) in the case that, during such plan year, such organization changed any terms of coverage for such item, service, or group of services, not take into account any claims for such item, service, or group of services that were submitted during the 90-day period beginning on the date of such change. (B) Prior authorization process For purposes of this subsection, the term prior authorization process means, with respect to coverage and payment for items and services (other than a covered part D drug) under an MA plan offered by an MA organization for a plan year, a process under which such organization (or a contractor of such organization) determines the medical necessity or medical appropriateness of such items and services prior to the furnishing of such items and services or that otherwise requires an individual enrolled under such plan, or a provider of services or supplier scheduled to furnish items and services to such individual, to notify such plan (or such contractor) prior to such individual receiving such items and services. (2) Frequency of determination of eligibility for exemption An MA organization may not evaluate a physician for the exemption described in paragraph (1) more than once during any plan year. (3) Notification requirements (A) Qualification An MA organization shall, not later than 30 days before the first day of each plan year, notify each physician who qualifies for the exemption described in paragraph (1) of such qualification and the items, services, or group of similar services with respect to which such exemption applies for such physician. Nothing in this subparagraph shall preclude an MA organization from notifying a physician of such exemption at additional times throughout a plan year. (B) Requests under exemption In the case of a physician described in subparagraph (A) who submits a prior authorization request to an MA organization for an item or service with respect to which an exemption applies under this subsection, such organization shall notify such physician of