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 an insurer would not impose prior authorization requirements for any service ordered by an in-network primary care provider.
Provides an insurer would not impose prior authorization requirements for any service ordered by an in-network primary care provider.
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.
Provides for a two-point three percent (2.3%) increase of provider reimbursement rates for intellectual and developmental disabilities commencing October 1, 2025.