CS for SB 784 - Right Medicine, Right Time Act

• Creates a 7-member Clinical Practices Review Commission within the Department of Health's Division of Medical Quality Assurance to review and approve coverage limitations based on clinical evidence, with members including 5 physicians, 1 pharmacologist, and 1 biostatistics expert.

• Requires managed care plans, health insurers, and health maintenance organizations to support all coverage limitations (prior authorization, step therapy, treatment protocols) with sufficient clinical evidence as defined by peer-reviewed research or multivariate predictive models.

• Establishes liability for insurers and their chief medical officers for injuries and damages resulting from coverage restrictions imposed without Office of Insurance Regulation approval, and requires insurers to establish reserves for such damages.

• Mandates insurers and health maintenance organizations post summaries on their websites identifying specific prescription drugs and diagnostic/therapeutic procedures subject to coverage limitations and provide links to preferred provider lists updated within 10 business days of changes.

• Prohibits health maintenance organizations from retroactively denying claims due to subscriber ineligibility if the organization verified eligibility at treatment and provided an authorization number.