CS for SB 530 - Health Insurer Authorization

• Revises prior authorization form requirements to not exceed two pages and prohibits requesting information unnecessary for determining medical necessity or coverage.

• Requires health insurers and pharmacy benefits managers to provide detailed descriptions of prior authorization requirements, restrictions, and forms on publicly accessible websites and in writing.

• Prohibits implementation of new prior authorization requirements or changes to existing ones unless posted on the insurer's website at least 60 days in advance and written notice is provided to affected policyholders and providers.

• Establishes 72-hour decision timeframes for nonurgent prior authorization requests and 24-hour timeframes for urgent care situations, with notification required to both patient and treating provider.

• Creates new "fail-first protocol" exceptions allowing insureds to bypass required step-therapy protocols when the preceding treatment is contraindicated, expected to be ineffective, previously failed, or not in the insured's best interest, with identical 72-hour and 24-hour decision timeframes.