Regards health insurance, Medicaid prior authorization

Mandates that all prior authorization requests be submitted and responded to via secure electronic transmission, with specific response times of 48 hours for urgent care and 10 days for other services.

Prohibits insurers and Medicaid from retroactively denying coverage for services that were previously approved by a physician, unless there is fraudulent or materially incorrect information.

Requires a streamlined appeal process where disputes are reviewed by an independent 'clinical peer' in the same specialty, with no fees charged for the appeal.

Sets a maximum 12-month duration for prior authorization approvals for chronic conditions, with exceptions for non-maintenance drugs, short-term treatments, and controlled substances.

Requires insurers and Medicaid to provide clear notice of any new prior authorization requirements at least 30 days before they take effect.

Defines 'chronic condition' as a medical issue persisting longer than six months despite reasonable treatment efforts, which triggers specific 12-month approval protections.

Updates effective dates for various provisions, setting most electronic and appeal requirements to take effect by January 1, 2018.