This bill proposes several updates to the Arizona Revised Statutes regarding prior authorization processes for health care services. It introduces new provisions that require health care insurers, pharmacy benefit managers, and utilization review agents to honor prior authorizations for a covered service for the first ninety days when a member changes health insurance, unless the service is excluded under the new plan. Additionally, it mandates that any changes in coverage or approval criteria after a prior authorization is granted will not affect the member for the remainder of their plan year.

Furthermore, the bill stipulates that insurers must publicly post all prior authorization requirements and provide a detailed description of clinical criteria in layman's terms. It also requires a sixty-day notice to enrollees before implementing any new or amended prior authorization requirements. Lastly, it establishes that prior authorizations for chronic or long-term care conditions remain valid for at least one year, and general prior authorizations are valid for at least six months, regardless of changes in prescription dosage.

Statutes affected:
Introduced Version: 20-2512