Health care coverage: prior authorizations.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Passed
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Overview
This bill aims to extend the validity period of prior authorizations for health care services. Currently, health care service plans and health insurers can rescind or modify prior authorizations after a provider has rendered the service in good faith. This bill would require prior authorizations to remain valid for at least one year, or throughout the course of prescribed treatment if it’s shorter than a year, ensuring patients receive consistent care from in-network providers. It also clarifies that these authorizations cannot be altered due to plan changes or determinations of eligibility.
Key provisions
- Prior authorizations for in-network providers must remain valid for at least one year.
- Prior authorizations can remain valid throughout the course of prescribed treatment if it’s less than one year.
- Health care service plans and health insurers cannot rescind or modify prior authorizations after a provider has rendered the service in good faith.
- The bill does not expand or alter benefits available to enrollees.
- The law clarifies that a violation of this bill by a health care service plan constitutes a crime.
- No state reimbursement is required for local agencies or school districts due to the creation of a new crime.
- The one-year validity period does not apply if the enrollee changes plans.
- Medication validity periods cannot exceed those established by state or federal law.
Who is affected
Bill text
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Sponsors
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1 on record
Primary sponsor
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