Us Congress 2023-2024 Regular Session

Us Congress Senate Bill SB4349

Introduced
5/15/24  

Caption

A bill to require private health plans to provide for secure electronic transmission of prior authorization requests for prescription drugs.

Impact

The implementation of SB4349 is expected to significantly impact state laws surrounding healthcare delivery. By standardizing electronic submissions for prior authorizations, the bill is poised to reduce the administrative burden on healthcare providers and improve the speed with which patients can receive prescribed medications. Moreover, the bill may lead to better tracking and management of authorization requests, contributing to improved patient outcomes and satisfaction.

Summary

SB4349 is a legislative bill aimed at modernizing the process of prior authorization requests for prescription drugs by requiring private health plans to use secure electronic transmissions. The bill mandates that for plan years beginning on or after January 1, 2027, health plans must permit healthcare professionals to submit prior authorization requests electronically. This requirement is intended to streamline the approval process for medications, enhancing efficiency and reducing delays in patient care.

Contention

Notably, discussions around SB4349 may highlight concerns regarding the cybersecurity of electronic transmissions, particularly regarding the sensitive information associated with prior authorization processes. Stakeholders are expected to debate the adequacy of the technical standards that the Secretary of Health and Human Services will set for these electronic systems, as well as the potential costs for health plans to implement these new technologies. Additionally, the implications for smaller healthcare providers, who may face challenges in adapting to these requirements, could also be a point of contention.

Companion Bills

No companion bills found.

Previously Filed As

US HB1134

Health insurance; if prior authorization request is approved for prescription drugs.

US SB98

Health insurance; if prior authorization request is approved for prescription drugs.

US SB644

Relating to the creation of a standard request form for prior authorization of prescription drug benefits.

US HB1032

Relating to the creation of a standard request form for prior authorization of prescription drug benefits.

US S2614

Requires a report to be produced that focuses on prescription drug prior authorizations by January 1, 2025.

US S0121

Requires a report to be produced that focuses on prescription drug prior authorizations by January 1, 2026.

US H7623

Requires a report to be produced that focuses on prescription drug prior authorizations by January 1, 2025.

US H5433

Requires a report to be produced that focuses on prescription drug prior authorizations by January 1, 2026.

US HB1808

Health insurance; creating the Ensuring Transparency in Prescription Drugs Prior Authorization Act; determination; consultation; prior authorization; effective date.

US SB27

Health care, require health insurer to act on prior authorization request or supplementation to prior authorization request within 72 hours of receipt with regard to prescriptions

Similar Bills

CA AB2789

Health care practitioners: prescriptions: electronic data transmission.

CA AB852

Health care practitioners: electronic prescriptions.

TX HB1966

Relating to an e-prescribing implementation plan under the Medicaid and child health plan programs.

CO HB1149

Prior Authorization Requirements Alternatives

OR SB841

Relating to tribal public health data.

MT SB449

Generally revise health utilization review laws

KS SB496

Expanding the scope of practice of naturopathic doctors, specifying continuing education requirements, increasing the required amount of professional liability insurance and modifying certain provisions relating to the licensure and regulations of naturopathic doctors.

KS SB121

Broadening the scope of practice of naturopathic doctors and changing certain provisions pertaining to the licensure and regulation of naturopathic doctors.