This bill amends existing laws regarding prior authorization requests for medical care covered by health care insurers in Alaska. It introduces a new process for prior authorization that mandates health care insurers to establish a reasonable and efficient system that minimizes administrative burdens on providers. The bill specifies timelines for insurers to respond to prior authorization requests, requiring determinations within 72 hours for standard requests and 24 hours for expedited requests. It also outlines the responsibilities of insurers to provide clear information about their prior authorization standards and to maintain a prior authorization application programming interface that facilitates communication between health care providers and insurers.

Additionally, the bill addresses step therapy protocols, particularly for patients with Stage 4 advanced metastatic cancer, ensuring that insurers cannot mandate step therapy for FDA-approved drugs. It establishes a process for health care providers to request exceptions to step therapy protocols and requires insurers to grant these exceptions under certain conditions. The bill also includes provisions for annual reporting by health care insurers to ensure compliance with the new requirements and outlines penalties for noncompliance. Overall, the legislation aims to enhance transparency, efficiency, and patient access to necessary medical care.

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