Prior authorization. Provides that a utilization review entity may only impose prior authorization requirements on less than 1% of any given specialty or health care service and 1% of health care providers overall in a calendar year. Prohibits a utilization review entity from requiring prior authorization for: (1) a health care service that is part of the usual and customary standard of care; (2) a prescription drug that is approved by the federal Food and Drug Administration; (3) medication for opioid use disorder; (4) pre-hospital transportation; or (5) the provision of an emergency health care service. Sets forth requirements for a utilization review entity that requires prior authorization of a health care service. Provides that all adverse determinations and appeals must be reviewed by a physician who meets certain conditions. Requires a utilization review entity to provide an exemption from prior authorization requirements if in the most recent 12 month period the utilization review entity has approved or would have approved at least 80% of the prior authorization requests submitted by the health care provider for a particular health care service. Repeals superseded provisions regarding prior authorization. Makes corresponding changes.
| Authored by Senator Johnson T |
| Title | Description | Date | View |
|---|---|---|---|
| Fiscal Note | Fiscal Note #1: Senate Comm Sub | 2024-01-19 | Click To View |
| Committee Report | Senate Committee Report | 2024-01-18 | Click To View |
| Vote Sheet | Vote Sheet January 17, 2024 | 2024-01-17 | Click To View |
| Fiscal Note | Fiscal Note #1: Introduced | 2024-01-11 | Click To View |
| Date | Chamber | Action |
|---|---|---|
| 2024-01-25 | Senate | Senator Randolph added as coauthor |
| 2024-01-22 | Senate | Senator Niezgodski added as coauthor |
| 2024-01-22 | Senate | Senators Buck and Zay added as coauthors |
| 2024-01-18 | Senate | Senator Yoder added as coauthor |
| 2024-01-18 | Senate | Senator Ford J.D. added as coauthor |
| 2024-01-18 | Senate | Senator Donato added as coauthor |
| 2024-01-18 | Senate | Senators Alting and Doriot added as coauthors |
| 2024-01-18 | Senate | Pursuant to Senate Rule 68(b); reassigned to Committee on Appropriations |
| 2024-01-18 | Senate | Committee report: do pass, adopted |
| 2024-01-16 | Senate | Senators Walker K and Alexander added as coauthors |
| 2024-01-16 | Senate | Senator Leising added as coauthor |
| 2024-01-16 | Senate | Senator Crider added as coauthor |
| 2024-01-16 | Senate | Senators Busch and Koch added as coauthors |
| 2024-01-16 | Senate | Senator Bohacek added as coauthor |
| 2024-01-16 | Senate | Senator Becker added as coauthor |
| 2024-01-16 | Senate | Senators Baldwin and Messmer added as coauthors |
| 2024-01-16 | Senate | Senators Brown L and Rogers added as coauthors |
| 2024-01-16 | Senate | Senator Garten added as third author |
| 2024-01-16 | Senate | Senator Charbonneau added as second author |
| 2024-01-16 | Senate | First reading: referred to Committee on Health and Provider Services |
| 2024-01-16 | Senate | Authored by Senator Johnson T |
