Mandatory Electronic Prior Authorization for Prescription Drugs in Private Health Plans.
This bill mandates that private health plans and insurers must use secure electronic transmission for all prior authorization requests and responses for prescription drugs, starting in 2027. This change aims to eliminate slow, paper-based processes like faxes, speeding up patient access to necessary medications. The goal is to streamline the administrative burden for both patients and healthcare providers.
Key points
Electronic Authorization Requirement: Private health plans must implement secure electronic systems for prior authorization requests and responses for prescription drugs.
Elimination of Faxes and Non-Standard Portals: Starting January 1, 2027, faxes, non-compliant proprietary portals, and simple electronic forms will not qualify as valid electronic transmissions.
Standardization: The Secretary of Health and Human Services will establish technical standards for these electronic transmissions to ensure security and interoperability.
Benefit for Patients: The standardization and digitization of the process are expected to reduce the waiting time for prescription drug approvals.
Expired
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