SB665 Summary

• Prohibits healthcare insurers from revoking or rescinding prior authorizations based on medical necessity unless they provide at least 3 business days' notice before the scheduled service date, with limited exceptions for subscriber ineligibility.

• Requires healthcare providers to make benefit inquiries to determine coverage before services are provided, with insurers obligated to respond within 10 business days of receiving complete information.

• Prohibits denial of prior authorization for prescription pain medication for subscribers with terminal illnesses.

• Exempts services that received prior authorization from audit recoupment by healthcare providers, except in cases of subscriber ineligibility or specific fraud/misrepresentation.

• Requires utilization review entities to implement automated electronic prior authorization systems by July 1, 2018, as an alternative to telephone-based systems, with the bill becoming effective August 1, 2017.