The bill amends existing laws in Alaska concerning prior authorization requests for medical care covered by health care insurers. It establishes a new process that requires insurers to create a system that reduces administrative burdens on providers, mandating responses to standard requests within 72 hours and expedited requests within 24 hours. If a request is incomplete, insurers must seek additional information within specified timeframes, and failure to respond within the designated period results in automatic approval of the request. The legislation also sets standards for prior authorization, requiring insurers to publish their criteria based on peer-reviewed, evidence-based clinical reviews, and it specifically addresses step therapy protocols to ensure patients with Stage 4 advanced metastatic cancer can access necessary FDA-approved medications without undue restrictions.

Furthermore, the bill clarifies the definition of "utilization review organization" to distinguish it from health care insurers, ensuring clearer guidelines for utilization review processes. It includes provisions for the director of the division of insurance to adopt regulations for implementing the Act, which will take effect in accordance with the Administrative Procedure Act, with certain sections becoming effective immediately and the remainder on January 1, 2027. The legislation aims to enhance transparency, efficiency, and patient access to medical treatments while establishing penalties for noncompliance, including potential suspension or revocation of an insurer's operating authority.

Statutes affected:
SB0133A, AM SB 133, introduced 03/17/2025: 21.07.080, 21.07.005, 21.07.090, 21.07.100, 21.07.180, 21.07.110, 21.07.120, 21.07.130, 21.07.140, 21.07.150, 21.07.160, 21.07.170, 21.06.120, 21.06.230, 21.07.250
SB0133B, AM CSSB 133(L&C), introduced 04/04/2025: 21.07.080, 21.07.005, 21.07.090, 21.07.100, 21.07.180, 21.07.110, 21.07.120, 21.07.130, 21.07.140, 21.07.150, 21.07.160, 21.07.170, 21.06.120, 21.06.230, 21.07.250
SB0133Z, AM Enrolled SB 133, introduced 05/18/2025: 21.07.080, 21.07.005, 21.07.090, 21.07.100, 21.07.180, 21.07.110, 21.07.120, 21.07.130, 21.07.140, 21.07.150, 21.07.160, 21.07.170, 21.06.120, 21.06.230, 21.07.250