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, including the criteria used for approvals and denials, and mandates the establishment of a peer review process for adverse determinations.

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 requires insurers to maintain a prior authorization application programming interface to streamline the process for health care providers and mandates annual reporting on compliance with these new requirements. The bill also includes definitions for key terms such as "chronic condition," "covered person," and "step-therapy protocol," and establishes penalties for noncompliance with the new regulations. The effective date for most provisions is set for January 1, 2027, while some regulations may take effect immediately.

Statutes affected:
HB0144A, AM HB 144, introduced 03/21/2025: 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
HB0144B, AM CSHB 144(HSS), introduced 04/09/2025: 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