Includes the definition of "primary care services" and requires that all biennial reports shall include a review and recommendation of rates for primary care services on and after September 1, 2025.
Includes the definition of "primary care services" and requires that all biennial reports shall include a review and recommendation of rates for primary care services on and after September 1, 2025.
Amends powers/duties of the office of the health insurance commissioner to increase total cost of care for services reimbursed under contracts after risk adjustment that exceeds the Consumer Price Index for all Urban Consumers percentage increase.
Amends powers/duties of the office of the health insurance commissioner to increase total cost of care for services reimbursed under contracts after risk adjustment that exceeds the Consumer Price Index for all Urban Consumers percentage increase.
Limits the use by insurers of step therapy, a protocol that establishes a specific sequence in which prescription drugs for a specified medical condition are covered by an insurer, by allowing medical providers to request step therapy exceptions.
Limits the use by insurers of step therapy, a protocol that establishes a specific sequence in which prescription drugs for a specified medical condition are covered by an insurer, by allowing medical providers to request step therapy exceptions.
Provides for a two-point three percent (2.3%) increase of provider reimbursement rates for intellectual and developmental disabilities commencing October 1, 2025.
Requires a report to be produced that focuses on prescription drug prior authorizations by January 1, 2026.