Bill > HF1269

This bill requires health insurance companies to provide comprehensive coverage for medical services and prescription medications used to treat or slow the progression of dementia. Specifically, health plan companies must cover all FDA-approved medical services and medications related to dementia, as well as diagnostic testing to determine the appropriateness of these treatments. The bill prohibits health insurers from using step therapy protocols (a process that requires patients to try less expensive treatments before accessing more specialized or costly medications) when providing dementia-related care. Additionally, the bill modifies existing medical assistance regulations by updating prior authorization requirements and ensuring that step therapy protocols align with new provisions for dementia treatment. The changes will apply to health plans offered, issued, or renewed on or after January 1, 2026, giving health insurance companies time to adjust their policies and coverage. By mandating this coverage, the bill aims to improve access to dementia treatments and ensure patients can receive potentially beneficial medical services without unnecessary administrative barriers.