WeVote
Log In

Bill

Bill

HB 1301

TO AMEND THE PRIOR AUTHORIZATION TRANSPARENCY ACT.

2025 Regular Session Introduced by Missy Irvin and 1 co-sponsor

House Bill 1301 allows qualifying healthcare providers to bypass prior authorization, improving access to services and reducing administrative burdens for patients and insurers.

Notification that HB1301 is now Act 511
0
WeVote Research Nonpartisan
Bill Summary · HB 1301

Summary of House Bill 1301: Amendment to the Prior Authorization Transparency Act

Bill Number: HB 1301
Status: Now Act 511
Introduced: January 29, 2025
Legislative Session: 95th General Assembly, Regular Session, 2025
Primary Sponsors: Representative L. Johnson, Senator Irvin

Purpose and Intent

House Bill 1301 aims to amend the Prior Authorization Transparency Act in Arkansas. The primary intent of the bill is to enhance the process of prior authorization for healthcare services, making it more transparent and efficient for healthcare providers. This includes the introduction of a "gold card program," which allows qualifying providers to bypass prior authorization requirements under certain conditions.

Key Provisions

  1. Gold Card Program Definition:

    • The bill introduces a new definition for the "gold card program," which allows healthcare providers to qualify for exemptions from prior authorization requirements based on their prior approval rates.

  2. Exemption Criteria:

    • Providers who receive approval for 90% or more of their prior authorization requests from January 1, 2022, to June 30, 2022, will be exempt from prior authorization requirements for specific services until September 30, 2024.
    • If a provider's service utilization increases by 25% or more from January 1, 2024, to June 30, 2024, the exemption may be revoked.

  3. Evaluation Process:

    • Healthcare insurers are required to evaluate the exemption status of providers based on claims submitted during the exemption period and must notify providers of their exemption status by October 1, 2024.

  4. Duration of Exemptions:

    • Exemptions granted will be valid for at least 12 months and can be renewed based on subsequent evaluations.

  5. Appeals Process:

    • The bill outlines a process for providers to appeal decisions regarding prior authorization denials, including the appointment of an independent review organization to assess appeals.

  6. Specific Exemptions for Prescription Drugs:

    • Prescription drugs and related services are exempt from the gold card program until December 31, 2024, unless specified otherwise.

Impact

  • Healthcare Providers: The bill primarily affects healthcare providers by reducing the administrative burden associated with prior authorization processes, potentially allowing for quicker access to necessary services for patients.
  • Healthcare Insurers: Insurers will need to adapt their evaluation processes and communication strategies regarding prior authorization exemptions.
  • Patients: Patients may benefit from improved access to healthcare services as providers navigate fewer prior authorization hurdles.

Procedural Timeline

  • January 29, 2025: Bill filed and read for the first time.
  • March 13, 2025: Amendments adopted and bill engrossed.
  • April 3, 2025: Passed by both the House and Senate.
  • April 10, 2025: Notification that HB 1301 is now Act 511.

This summary provides an overview of the essential components of HB 1301, highlighting its purpose, key provisions, and the anticipated impact on healthcare in Arkansas.

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

Sign in to ask a question.