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Senate amends and passes H766 to narrow prior-authorization exemptions for primary care
Summary
The Senate amended H766 to limit prior-authorization exemptions to primary care providers and added reporting requirements, then passed the bill on third reading. Supporters framed the change as an incremental step to reduce administrative burden for frontline providers.
The Vermont Senate on April 26 adopted amendments to H766, an act addressing prior authorization, step therapy, health-insurance claims and provider contracts, and then passed the bill on third reading.
Senators described the adopted amendment as a targeted, incremental approach that would remove prior-authorization requirements at the primary-care level while preserving oversight elsewhere. The reporter explained the change was intended to reduce administrative burden on primary-care providers and allow time to evaluate downstream effects through reports from payers and providers.
Committee members noted the amendment keeps prior authorization for out-of-network prescriptions and certain specialty drugs and that follow-up reporting, including actuarial analysis, would be required after implementation. During floor interrogation senators asked whether the Department of Financial Regulation or other agencies could provide actuarial or earlier-read analyses; the reporter said such analyses could be requested.
After the floor acceptance of the handout amendment (to conform a prescribing provision to federal law) and the broader amendment limiting prior-authorization at primary care, the Senate voted and passed H766 on third reading.
The bill will proceed to the next steps for enactment and implementation, with committee monitoring and required reports to help gauge cost and access impacts.
