Health care utilization review provisions and prior authorization clinical criteria applicability modified.

HF 2482 modifies rules for when health insurance plans can change prior authorization requirements for medical services or drugs. It requires plans to maintain existing coverage terms or clinical criteria for current enrollees until the next plan year, unless changes relate to FDA safety warnings, drug withdrawals, or evidence-based recommendations about patient harm. The bill also mandates that if a plan removes a brand-name drug from its formulary or increases patient costs, it must add a cheaper generic or biosimilar equivalent and provide 60 days' notice to prescribers and patients. These changes apply to all health benefit plans starting January 1, 2026, and extend to state health programs under chapters 256B and 256L.