In Review: The Health Coverage, Insurance, and Financial Services Committee (HCIFS) held a hearing on Senate President Jackson’s (D) nonopioid, a nonnarcotic bill, which would allow for a patient to request a nonopioid and prior authorizations may not be stricter than an opioid. PCMA testified in opposition, citing concerns with limiting prior authorizations. PCMA also testified in opposition to another Senate President Jackson bill requiring coverage of the lowest WAC price insulin at no cost share. Previously the committee voted ought to pass on an amended prior authorization bill, but HCIFS voted to reconsider the bill as the sponsor was concerned the final amendment did not reflect the outcome she was seeking. The bill sponsor wants to add back in the provision that prevents a carrier from denying a claim for a covered, medically necessary, non-emergency service for failure to achieve prior authorization and limit any penalty a carrier would apply to no greater than 10% of the contractually allowed amount. PCMA will work with the bill sponsor as we oppose this provision.

Up Next: HCIFS has a hearing on Tuesday, February 20 on Senate President Jackson’s bill requiring coverage of generics and biosimilars. PCMA will testify in opposition to the bill.

If you have any questions, please contact Sam Hallemeier at shallemeier@pcmanet.org.