MS HB1497

Prohibits health benefit plans, pharmacy benefit managers, and private review agents from requiring prior authorization, step therapy, or other restrictive protocols for antiretroviral (ARV) drugs approved by the FDA for HIV or AIDS treatment.

Requires coverage of at least one therapeutically equivalent ARV drug per route of administration without prior authorization or step therapy if multiple FDA-approved options exist.

Amends Section 83-9-36 to clarify that step therapy duration cannot exceed 30 days when deemed clinically ineffective, with possible 7-day extension if additional time is medically justified.

Amends Section 83-5-909 to prohibit prior authorization requirements for therapeutically equivalent HIV/AIDS drugs and updates prior authorization disclosure requirements for health insurance issuers.

Takes effect July 1, 2025, and applies to Medicaid fee-for-service programs, managed care programs, and private health insurance plans.