Mississippi 2024 Regular Session

Mississippi House Bill HB1602

Introduced
2/19/24  
Refer
2/19/24  

Caption

Override of step therapy or fail-first protocol; require insurer to decide within certain time.

Impact

The bill's implementation is poised to enhance the decision-making power of healthcare providers and provide greater access to necessary medications for patients. By defining strict timelines for insurers to respond to override requests, the legislation seeks to eliminate bureaucratic delays that can hinder patient care. In cases where insurers do not respond within the allotted time, the request for an override will be automatically granted, thus bolstering patients' rights to receive timely treatments as prescribed by their doctors.

Summary

House Bill 1602 seeks to amend Section 83-9-36 of the Mississippi Code of 1972, focusing on the regulation of step therapy and fail-first protocols used by insurers. The bill mandates that insurers must grant or deny requests for overrides of these protocols within a specified timeframe—72 hours normally, and 24 hours in urgent cases. This provision aims to expedite insurance decision-making in cases where practitioners believe that mandated treatments are ineffective or harmful for their patients. The legislation is intended to create a more accessible and responsive healthcare system for patients who may face delays under current protocols.

Contention

Despite its positive implications, the bill has faced some contention. Critics express concerns regarding the feasibility of insurers operating under such strict timelines, arguing that it might lead to operational challenges and potential increases in insurance costs. Additionally, there may be concerns about the potential for misuse of the expedited override process, thereby complicating insurer relationships with medical providers. Nonetheless, the overarching objective of HB1602 is to facilitate broader patient access to compatible and effective treatment options, emphasizing the alignment of medical decisions with patient needs over administrative restrictions.

Companion Bills

No companion bills found.

Previously Filed As

MS HB1317

Pharmacists; authorize to test for and administer treatment for minor, nonchronic health conditions.

MS HB316

Health insurance; require certain policies to provide coverage for physician-prescribed proton beam therapy.

MS HB187

Medicaid; require managed care organizations to use certain level of care guidelines in determining medical necessity.

MS HB854

Marriage and family therapists; revise certain requirements for licensure.

MS HB572

State Health Insurance Plan; provide coverage for proton therapy to treat cancer and certain noncancerous tumors.

MS HB1135

Prior authorization; bring forward code sections related to.

MS HB421

Physical therapists; delete requirement for physicians referral before performing services.

MS SB2147

Physical therapy practice laws; revise various provisions of.

MS HB826

Fresh Start Act; revise certain provisions of.

MS HB1082

Child support; require insurers to provide MDHS certain information for noncustodial, delinquent parents.

Similar Bills

CA AB1998

Opioids: safe prescribing policy.

MS SB2069

Health insurance; require health benefit plans to follow new procedure related to step therapy protocol for CRF-COPD treatment.

MS SB2257

Health insurance; require health benefit plans to follow new procedure related to step therapy protocol for CRF-COPD treatment.

MS HB1143

Advanced Metastatic Cancer; prohibit health plans from requiring step therapy before covering certain drugs to treat.

MS SB2264

Health insurance policies; prohibit step therapy requirements for certain prescription drugs to treat advanced cancer.

VA HB2497

Midwifery; administration of medication within scope of practice.

VA HB1511

Midwifery; administration of medication.

NM SB135

Step Therapy Guidelines