HB 2190 Summary

• Defines "health benefit plan" as a plan providing medical or surgical expense benefits for health conditions, accidents, or sickness, offered by insurers, hospital service corporations, health maintenance organizations, or similar entities.

• Excludes certain coverage types from the definition of health benefit plan, including specified disease plans, accidental death/dismemberment, dental/vision, Medicare supplements, workers' compensation, motor vehicle insurance, and short-term policies of 6 months or less.

• Requires health benefit plans to use standardized prior authorization forms for prescription drug benefits, effective January 1, 2015, to establish uniformity in submission procedures.

• Limits prior authorization forms to a maximum of 3 pages in length, excluding instructions or guiding documentation, while allowing plans to customize content for specific drugs.

• Requires health benefit plans to make prior authorization forms accessible through multiple computer operating systems and provide copies to the Insurance Commissioner upon request.

• Effective date: November 1, 2014.