AN ACT CONCERNING STEP THERAPY, ADVERSE DETERMINATION AND UTILIZATION REVIEWS.
To (1) prohibit certain health carriers from requiring the use of step therapy for drugs prescribed to treat behavioral health conditions or chronic, disabling or life-threatening conditions or diseases; (2) redefine "clinical peer" for the purposes of adverse determination and utilization reviews; (3) require health carriers to bear the burden of proving that certain health care services under adverse determination or utilization review are not medically necessary; and (4) require health carriers to provide certain clinical peers with authority to reverse initial adverse determinations.
Introduced by:
Sen. Saud Anwar, 3rd Dist.
