Bill > HB63

This bill requires health benefit plans in Georgia to establish step therapy protocols, which are evidence-based procedures that specify the sequence in which prescription drugs should be used for a particular medical condition. The bill provides for a step therapy exception process, where the prescribing provider can request an exception to the step therapy protocol if certain conditions are met, such as the required drug causing adverse effects or being expected to be ineffective for the patient. The health benefit plan must grant or deny the exception request within a specified timeframe, and if approved, must immediately authorize coverage for the prescribed drug. The bill also outlines certain limitations to its applicability, such as not preventing health plans from requiring the use of generic or interchangeable drugs. The bill applies to health benefit plans delivered, issued, or renewed in Georgia on or after January 1, 2020.