ADD CLASSES TO PRIOR AUTHORIZATION DRUGS

Added new definitions for 'auto-adjudicate', 'off-label', 'pend', and 'pharmacy benefits manager' to clarify how technology and specific medication types are handled under the law.

Modified prior authorization requirements to mandate the use of electronic portals for processing requests and to require auto-adjudication of electronically transmitted requests.

Added requirements for health insurers to provide electronic receipts and tracking numbers for all prior authorization requests to improve transparency and patient tracking.

Added strict timelines requiring health insurers to respond to prior authorization requests within 24 hours for expedited requests and within seven days for standard requests.

Modified eligibility criteria by expanding the definition of 'medical necessity' to include practice guidelines developed by federal, national, or professional medical societies.