Bill
SR 170
Creates a study task force to evaluate forming an independent review board to resolve cancer prior-authorization disputes, aiming for faster care and reduced clinician burden.
Title: HEALTH CARE — Creates a task force to study the feasibility of forming an independent review board to assist cancer patients and healthcare providers with prior authorization processes that do not comply with the Cancer Patient's Right to Prompt Coverage Act
Status
- Classification: Senate Resolution
- Introduced: February 25, 2025
- Current status: Enrolled — signed by the President of the Senate and sent to the Secretary of State (final procedural steps completed in the Senate).
- Related/companion measures: HR 78, SCR 189.
Purpose and intent
- The resolution establishes a task force to study whether an independent review board (IRB) should be created to help cancer patients and treating providers resolve problematic prior authorization decisions by insurers that violate (or appear to violate) the state’s Cancer Patient’s Right to Prompt Coverage Act.
- The study aims to identify whether an IRB would improve timely access to cancer diagnosis and treatment, reduce administrative burdens on clinicians, and increase insurer compliance with the existing statute.
Key provisions (based on available summary information)
- Creation of a study task force (non‑legislative body) charged with assessing the feasibility of establishing an independent review board to adjudicate or facilitate resolution of prior authorization disputes affecting cancer care.
- Scope of the study (typical elements likely included, though the enrolled resolution text was not provided in full):
- Define the proposed IRB’s purpose, authority, and operational model (e.g., advisory vs. binding decisions).
- Recommend membership composition (patients, oncologists, payor representatives, ethicists, regulatory/legal experts).
- Evaluate processes and timelines for expedited reviews consistent with cancer‑care urgency.
- Analyze costs, staffing needs, and funding sources.
- Assess statutory or regulatory changes needed to implement the IRB and ensure enforceability.
- Consider data collection, confidentiality, and reporting requirements to monitor insurer compliance.
- Requirement to prepare a written report with findings and recommendations to the Legislature and relevant state agencies (the enrolled summary does not include a specific reporting deadline or appropriation).
Who would be affected
- Primary beneficiaries: cancer patients who face delays or denials through prior authorization procedures; their families.
- Healthcare providers: oncologists, hospitals, clinics and other treating providers who manage prior authorization appeals and care coordination.
- Payers and insurers: private health plans, Medicaid managed care organizations and other entities that use prior authorization for cancer‑related services.
- State health regulators and the Legislature: would receive the task force report and consider subsequent legislative or regulatory action.
Potential impacts
- If the task force recommends creating an IRB and the Legislature implements it, potential benefits include faster resolution of authorization disputes, reduced treatment delays, clearer standards for insurer compliance, and decreased provider administrative burden.
- Potential costs and tradeoffs include administrative and implementation expenses, insurer pushback or litigation over authority of the IRB, and the need to balance expedited cancer care with utilization controls and cost containment.
Procedural notes and missing details
- As a resolution establishing a study, SR 170 is a non‑binding, investigatory measure (it does not itself change insurance law or create regulatory authority). Any IRB creation or statutory changes would require subsequent legislation.
- The enrolled material provided does not include the full text of the resolution: specific task force membership, reporting deadlines, meeting requirements, or any appropriation to support the study were not available. For implementation‑level details, consult the official enrolled resolution text or agency materials filed with the Secretary of State.
Compiled from official sources — confirm details with the bill’s official record.
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