House concurs with Senate changes to limit prior authorizations and exempt primary care for many orders

After extended floor debate, the House concurred in the Senate proposal of amendment to H.766, a measure restricting prior authorization and step‑therapy requirements for certain health care services and prescription drugs.

The Senate amendment adopted by the House exempts orders placed by primary care providers from prior authorization requirements in most cases, while carving out exceptions for prescription drugs and out‑of‑network procedures. The amendment also requires health plans and pharmacy benefit managers to cover at least one readily available asthma controller medication for each class and mode of administration without prior authorization, a change supporters said will improve access for children with asthma.

Members who support the change described the administrative burden prior authorizations impose on primary care offices and clinicians. A retired family nurse practitioner said the process can take hours and reduce time available to see patients. Multiple members recounted personal experiences of delayed or denied care because of prior authorization hurdles.

Opponents cautioned the changes could increase premiums and noted the law would apply primarily to state‑regulated plans (roughly a portion of the market); one member said the timing of substantive changes raises concerns because rate filings for 2025 were imminent.

The House completed a roll call on the concurrence and the clerk announced: those voting yes, 104; those voting no, 24. The House concurred in the Senate proposal of amendment and ordered third reading when appropriate.