FL H0559

Health insurers and pharmacy benefit managers must offer secure online electronic prior authorization processes effective January 1, 2020, and contracted providers must use these electronic systems to request prior authorizations

Prior authorization forms are limited to two pages and must include patient identification, provider information, medical procedure/treatment requested with reasoning, required laboratory documentation, and accuracy attestation

Health insurers cannot require insureds to repeat step therapy protocols if the patient was previously approved for a prescription drug through another insurer's step therapy and has received payment for the drug within the prior 90 days

New insurers may still impose prior authorization requirements for continued drug coverage, but are not required to add drugs to their formulary or cover non-covered uses to comply with step therapy provisions

Applies to contracts entered into or renewed on or after January 1, 2020, but excludes Medicaid managed care plans; effective date is July 1, 2019