PRIOR AUTHORIZATION & PRESCRIPTION DRUGS

Summary

The bill updates the state's Prior Authorization Act, forcing health insurers and pharmacy benefits managers to use a uniform electronic form, auto‑adjudicate requests, and decide within seven days (or 24 hours for emergencies). It removes prior‑authorization and step‑therapy requirements for drugs treating autoimmune disorders, cancer, rare diseases, serious mental illness, and substance‑use disorders, and limits repeat authorizations for chronic maintenance drugs to once every three years. The changes aim to speed access to critical medicines while adding oversight and penalties for non‑compliance.

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