Prior Authorization – Other
ACT 254 by Sen. Kirk Talbot • Began as SB 110 • Establishes the "Cancer Patient's Right to Prompt Coverage Act". • Includes timelines similar to Rep. Pressly’s ACT 312. • For diagnosis and treatment of cancer, requires coverage of services for nationally recognized clinical practice guidelines. • Prohibits denial of coverage of recommended imagining for diagnosis, treatment, appropriate management, restaging… • Effective date of 8/1/2023 – But doesn’t apply to policies until 1/1/2024
SB 164 by Sen. Heather Cloud
• Focuses on the Office of Group Benefits which is the health insurance plan for employees and retirees of the State. • Mandates posting of all services and pharmaceuticals requiring prior authorization. • Failure deems them to no longer require a prior authorization. • Establishes reporting requirements very similar to what is in SB 188 by Sen. Stine. • Fiscal Note had it dually referred. • Ran out of time.
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