Prior authorization policies require a health care provider or an insurance plan enrollee to obtain approval from the insurer or its pharmacy benefit manager before the plan will cover the cost of a health care product or service. This practice can delay access to life-saving treatments and can be applied in a manner that is inconsistent with medical standards of care.
States have introduced legislation to address the prior authorization process. Please click on the map below for state-specific information on legislation introduced this session.
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