Prior authorization; requiring physician review for denial.

The document layout was changed to include large margins, extra line breaks, and a 'House Substitute' header, likely for internal committee tracking or formatting purposes.

A bill tracking number (26106401D) and a timestamp were inserted into the text, which are administrative identifiers rather than legal changes.

The original clean formatting, including the 'OFFERED FOR CONSIDERATION' date and standard spacing, was removed in favor of the new substitute layout.

The bill's status changed from 'Enrolled' (final) to 'Offered for Consideration' (draft), indicating it is no longer in its final form but is being reviewed by the House Committee on Labor and Commerce.

New header information was added identifying the bill as a substitute proposed by the House Committee on Labor and Commerce, with Delegate Hope listed as the original patron.

The 'Enrolled' designation and approval stamp were removed, as the bill is no longer in its final, signed state.

The text was converted from a draft legislative format to the official enrolled format, including the addition of page headers, the 'Approved' signature line, and the removal of committee referral information.