An act relating to prior authorization and step therapy requirements, health insurance claims, and provider contracts

This bill requires health insurance plans and pharmacy benefit managers to limit step therapy requirements for prescription drugs, allowing exceptions when a medication is contraindicated, ineffective, or not in the patient's best interest. It also prohibits requiring documented medication trials before approving prescriptions for substance use disorder treatment and mandates coverage of at least one readily available asthma controller medication without prior authorization. Additionally, the law restricts prior authorization requirements for services ordered by primary care providers, with exceptions for prescription drugs and out-of-network care. The Vermont Department of Financial Regulation is tasked with enforcing these provisions.