This bill aims to eliminate the requirement for pre-approval or precertification of cancer-related treatments, tests, procedures, and prescription drugs under health benefits and prescription drug benefits plans. It specifically prohibits health insurers, third-party administrators, pharmacy benefits managers, and both the State Health Benefits Program and the School Employees Health Benefits Program from imposing such conditions when these services are prescribed by licensed healthcare providers for individuals diagnosed with cancer. The intent is to streamline access to necessary medical care for cancer patients, who often face delays due to bureaucratic processes.
The sponsor of the bill expresses concern over the increasing complaints from patients regarding the burdensome pre-approval processes imposed by insurance companies, which can hinder timely access to care. By removing these requirements, the bill seeks to empower healthcare providers to make decisions based on patient needs rather than insurance company protocols, thereby alleviating the frustrations faced by cancer patients and ensuring they receive the treatments they require without unnecessary delays. The bill is set to take effect immediately for health benefits plans or prescription drug benefits plans issued or purchased after its enactment.