House Bill No. 1808 aims to enhance regulations surrounding health insurance, specifically focusing on prescription drug coverage and prior authorization processes. The bill introduces new definitions related to health benefit plans and health care services, and it mandates that health insurers and pharmacy benefit managers implement step-therapy protocols that do not require patients to fail on the same medication multiple times. It also allows exceptions to these protocols based on specific medical conditions or prior treatment history. Additionally, the bill stipulates that health plans must respond to urgent and nonurgent prior authorization requests within set timeframes, and if they fail to do so, the requests will be deemed approved.

Furthermore, the bill empowers the Insurance Department to create rules that limit prior authorization requirements for generic medications and treatments with low variation in provider usage. It establishes penalties for violations of these provisions, with fines ranging from $100 to $1,000 per occurrence. The legislation explicitly states that it does not apply to medical conditions or procedures, and it is set to take effect on November 1, 2025.