Amends TCA Title 8; Title 53; Title 56; Title 63; Title 68 and Title 71.

Present law provides that if a health carrier, health benefit plan, or utilization review organization denies coverage of a prescription drug for the treatment of a medical condition through the use of a step therapy protocol, then the health carrier, health benefit plan, or utilization review organization must provide access to a clear, readily accessible, and convenient process for a patient or prescribing practitioner to request a step therapy exception. The process must be easily accessible on the website of the health carrier, health benefit plan, or utilization review organization. This bill adds to the present law by prohibiting a health carrier, health benefit plan, or utilization review organization from using step therapy protocols as the basis to restrict, delay, or deny coverage of a prescription drug or drug regimen for the treatment of cancer or associated conditions if at least one of the following criteria is met: (1) The prescribed drug or drug regimen is consistent with best practices for the treatment of cancer or associated conditions; (2) The prescribed drug or drug regimen is supported by peer-reviewed, evidence-based medical literature; or (3) The prescribed drug or drug regimen has the U.S. FDA-approved indication. As used in this bill, "associated conditions" means the symptoms or side effects associated with cancer, or the treatment of cancer, which, in the judgment of the healthcare practitioner, further jeopardize the health of a patient if left untreated. APPLICABILITY This bill applies to agreements for health insurance or health plans entered into, issued, delivered, amended, or renewed on or after July 1, 2024.