Limits insurers' use of step therapy protocols by allowing medical providers to request exceptions.

This bill restricts insurers' use of step therapy protocols, which establish a specific sequence for covering prescription drugs. It allows medical providers to request exceptions if the required step is contraindicated, ineffective, delays care, disrupts stable treatment, or hasn't been tried. Insurers must provide uninterrupted coverage while the exception is pending and approve or deny requests within specific timeframes. The bill also mandates insurers to share prior authorization requirements and criteria with providers and patients.

Limits insurers' use of step therapy protocols by allowing medical providers to request exceptions.

This bill restricts insurers' use of step therapy protocols, which establish a specific sequence for covering prescription drugs. It allows medical providers to request exceptions if the required step is contraindicated, ineffective, delays care, disrupts stable treatment, or hasn't been tried. Insurers must provide uninterrupted coverage while the exception is pending and approve or deny requests within specific timeframes. The bill also mandates insurers to share prior authorization requirements and criteria with providers and patients.