Bill No. 1811 amends existing insurance law regarding the treatment of chronic conditions and the validity period for prior authorization of both inpatient and non-inpatient care. The bill stipulates that prior authorization for non-inpatient care must remain valid for at least six months, while for inpatient acute care, it is valid for a minimum of fourteen calendar days. Additionally, if an enrollee requires extended inpatient care beyond the initially approved duration, the utilization review entity must evaluate the request without applying stricter criteria than those used for the initial authorization.

A significant change in the bill is the reduction of the timely request period for continuation of inpatient care from seventy-two hours to twenty-four hours before the termination of the previously approved authorization. If the utilization review entity does not respond to a timely request, the health benefit plan is required to continue compensating the healthcare provider at the contracted rate until a determination is made. The bill is set to take effect on November 1, 2025.