Bill > S677

This bill aims to restrict prior authorization and retrospective review requirements for certain prescription drugs under private health insurance, Medicaid, and the state Group Insurance Commission. Specifically, the bill prohibits prior authorization for generic drugs not listed as controlled substances, prescription drugs after 6 months of use, certain therapeutic duplicates, and adjustments in medication dosage. It also requires that adverse determinations during prior authorization be made by a physician in the same specialty as the prescriber or focused on the relevant condition. Additionally, the bill limits retrospective review in certain circumstances and establishes an expedited grievance process for adverse prior authorization decisions.

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https://malegislature.gov/Bills/193/S677