Relating to patient-centered treatment flexibility within the Public Employees Insurance Agency

Summary

The bill lets a patient who already has prior authorization for a covered treatment receive a different, medically appropriate covered treatment for the same condition without obtaining a new authorization. The Public Employees Insurance Agency must cover the alternative if its cost does not exceed the original treatment’s allowed cost. Providers must document the medical appropriateness, and the agency cannot impose unreasonable delays or require a new prior authorization.

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