The "Patients' Right to Transparency and Timely Access to Healthcare Services Act" aims to improve the transparency and efficiency of the healthcare services authorization process in South Carolina. The bill introduces a new chapter to the South Carolina Code of Laws, establishing guidelines for prior authorization requirements. Key provisions include an exemption for healthcare providers with an eighty percent approval rate for prior authorization requests for twelve months, and a mandate for health carriers to provide a fair prior authorization process, including timelines for decisions. The bill also specifies healthcare services that cannot require prior authorization, such as certain preventive services, outpatient mental health treatments, and pain medication for terminally ill patients.

Additionally, the bill enhances patient access to healthcare by prohibiting prior authorization for prehospital transportation and emergency medical care, ensuring compliance with existing laws. It establishes that authorizations for chronic conditions remain valid throughout treatment, while prescription drug authorizations are valid for the policy year. The legislation also outlines requirements for step therapy protocols, ensuring transparency and a clear process for exceptions. Health carriers are required to honor prior authorizations from previous plans for at least sixty days and report metrics related to prior authorization and step therapy exceptions to the Department of Insurance annually. The act will take effect upon the Governor's approval and will apply to plans renewed after January 1, 2027.