Provides for utilization review and approval procedures of claims for healthcare provider services.

Provides for balance billing by and reimbursement of covered health services provided by out-of-network emergency ambulance services.

Provides for patient’s right to prompt coverage. Proposed law establishes the “Cancer Patient’s Right to Prompt Coverage Act”. Proposed law adds definitions for health coverage plan, health insurance issuer, nationally
recognized clinical practice guidelines, consensus statements, prior authorization, utilization review,
and positron emission tomography.

Provides relative to the 340B drug pricing program

Proposed law the term/provisions related to telemedicine and provides that telehealth includes a physician’s practice of medicine when provided through electronic communications. Proposed law no longer requires a healthcare provider to conduct an in-person patient history or physical examination of the patient before engaging in a telehealth encounter, but shall provide a referral to a healthcare provider in this state or arrange for follow-up care in this state as necessary.

Provides relative to health coverage plan benefits for occupational therapy services delivered via telehealth

Authorizes substitution of certain biosimilar biological products relative to step therapy or fail first protocols