The bill amends the Prior Authorization Act to prohibit health insurers from requiring prior authorization for specific covered services, including chemotherapy, dialysis, elder care, and home health care services. It allows insurers to require notification from healthcare providers after the initiation of these services and permits the development and submission of treatment plans that comply with federal law. This change aims to streamline access to essential medical services for patients.

Additionally, the bill modifies existing provisions regarding prior authorization for prescription drugs. It specifies that medications approved by the FDA for treating autoimmune disorders, cancer, diabetes, high blood pressure, or substance use disorders will not be subject to prior authorization, except when a biosimilar, interchangeable biologic, or generic version is available. This amendment is intended to enhance patient access to necessary medications while maintaining some oversight in cases where alternatives exist.

Statutes affected:
introduced version: 59A-22B-1, 59A-22B-8