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Bill

HSB 19

A bill for an act relating to prior authorizations and exemptions by health benefit plans and utilization review organizations.

2025-2026 Regular Session

HF 303 streamlines healthcare access by exempting certain primary care providers from prior authorization, reducing administrative burdens and improving patient care.

Committee report approving bill, renumbered as HF 303.
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Bill Summary · HSB 19

Summary of HSB 19 (Renumbered as HF 303)

Purpose and Intent

House Study Bill 19 (HSB 19), now renumbered as HF 303, aims to reform the prior authorization process required by health benefit plans and utilization review organizations in the state. The bill seeks to streamline healthcare access by establishing a pilot program that exempts certain healthcare providers from prior authorization requirements, thereby reducing administrative burdens and improving patient care.

Key Provisions

  • Implementation Timeline: Health carriers must implement the pilot program by January 15, 2026.
  • Exemption Criteria: The program will exempt a subset of participating providers, particularly primary healthcare providers, from prior authorization requirements.

  • Information Disclosure: Each health carrier is required to provide detailed information on their website regarding:

    • Criteria for provider eligibility in the exemption program.
    • Healthcare services exempt from authorization.
    • Estimated number of eligible providers, including their specialties and the percentage that are primary care providers.
    • Contact information for consumers and providers to inquire about the exemption program.

  • Reporting Requirements: By January 15, 2027, health carriers must submit a report to the commissioner of insurance that includes:

    • Results of the pilot program.
    • Analysis of costs and savings associated with the program.
    • Recommendations for continuing or expanding the program.
    • Feedback received from providers and consumers.
    • Assessment of administrative costs incurred by the carriers in managing authorization requirements.

Affected Parties

  • Health Carriers: All health carriers delivering, issuing, or renewing health benefit plans in the state will be impacted by the new requirements.
  • Healthcare Providers: Primary care providers and other participating providers who meet the criteria will benefit from reduced administrative burdens.
  • Consumers: Patients may experience improved access to healthcare services due to the streamlined authorization process.

Legislative Actions

  • Introduced: January 15, 2025, and referred to the Commerce Committee.
  • Committee Actions:
    • Subcommittee recommended passage on January 23, 2025.
    • Committee voted unanimously in favor (23 Yeas, 0 Nays) on February 6, 2025.
    • The bill was approved and renumbered as HF 303 on February 10, 2025.

Conclusion

HSB 19 (HF 303) represents a significant step towards improving the efficiency of healthcare delivery in the state by reducing the complexities associated with prior authorizations. By establishing a pilot program for exemptions, the bill aims to enhance the healthcare experience for both providers and patients, while also ensuring accountability through reporting requirements.

Compiled from official sources — confirm details with the bill’s official record.

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