Prior authorization commission establishment

SF 1739 establishes a Prior Authorization Commission to review medications with high denial rates for prior authorization. The commission, composed of nine members representing health agencies, pharmacy benefit managers, health plans, and medical associations, will analyze the top 25 medications with the highest denial rates using criteria like cost, effectiveness, and population utilization. It will recommend specific medications for inclusion in a list where prior authorization is prohibited, requiring health plans to cover these medications without prior review. The commission must submit annual reports to the legislature starting in 2026, detailing its analysis and recommendations, directly affecting health plans, pharmacy benefit managers, and patients seeking covered medications.