On May 20, 2024, Governor Phil Scott signed H.766, which aims to reform prior authorization practices and reduce administrative delays to improve patient care in Vermont. The new law eliminates prior authorization for any in-network service ordered by a primary care provider, ensuring timely access to necessary treatments. It also mandates prompt response times for authorization requests: insurers must respond to urgent requests within 24 hours and non-urgent requests within two business days. Additionally, the bill includes protections such as making prior authorization approvals valid for the duration of the treatment or one year, with renewals required no more than every five years, and guaranteeing that patients stable on a treatment from a previous plan will have coverage for at least 90 days after switching plans. The bill also creates new requirements for step therapy within the state including prohibiting patients from trying-and-failing on a previously failed drug; if the drug is likely to cause an adverse reaction; or if the drug is likely to be ineffective.
Read the bill here. Read Gov. Scott’s signing letter here.
Last Updated on October 14, 2024 by Aimed Alliance
