FL S0098

Redefines "health insurer" to specify coverage of individual or group health insurance policies providing major medical or comprehensive coverage, managed care plans, and health maintenance organizations.

Prohibits prior authorization forms from requiring information unnecessary for determining medical necessity or coverage, with the Financial Services Commission authorized to adopt rules prescribing necessary information.

Requires health insurers and pharmacy benefits managers to provide prior authorization requirements, restrictions, and forms on publicly accessible websites and in writing, with 60 days' notice before implementing new or changed requirements.

Establishes response timeframes for prior authorization decisions: 72 hours for nonurgent care situations and 24 hours for urgent care situations.

Creates "fail-first protocol" exception procedures allowing patients and providers to request exceptions to required treatment sequences, with insurers required to grant exceptions under specific circumstances including medical contraindications, expected ineffectiveness, previous treatment failure, or opioid-to-nonopioid transitions.