Bill > H1001

This bill revises contract requirements for managed care programs, including mandates for health plans to provide a broad range of therapeutic drug options and include newly FDA-approved drugs on their formularies for a period until review, with provisions for patients to continue a previously prescribed drug if medically necessary even if it's removed or changed from the formulary. It also establishes a process for providers to request an override of "step-therapy" or "fail-first" protocols, which require patients to try a specific drug before another, and mandates that plans grant these overrides within 24 hours if the prescribed drug has been ineffective or is likely to cause adverse reactions, with exceptions for certain circumstances. Additionally, the bill prohibits health insurers and health maintenance organizations (HMOs) from retroactively denying claims if they verified a patient's eligibility and provided an authorization number at the time of treatment, requires insurers to post provider information on their websites and update it promptly, and repeals provisions related to grace periods for health maintenance contracts.