It is no secret that prior authorization has long been a sore subject between payers and providers.
In June 2025, insurers committed to easing prior authorization requirements. Now, AHIP (formerly American’s Health Insurance Plans) and the Blue Cross Blue Shield Association have reported an 11% drop in prior authorizations since then.
The update came shortly after payers had to publish denial rates and related data for the first time. KFF had trouble extracting insights since the data was aggregated and not broken down by service type. Payers also did not have to report on decision rationales.
Meanwhile, states have been taking their own steps to address ongoing prior authorization concerns.
Here are five states that have rolled out laws in 2026:
1. Virginia: On April 6, Democratic Gov. Abigail Spanberger signed HB736 into law, establishing minimum durations of at least six months for initial requests and 12 months for continued requests. The law also introduced a few specific exceptions to these requirements.
2. Washington: This state law, signed by Democratic Gov. Bob Ferguson March 23, says AI algorithms can only approve prior authorizations, not deny them without a health professional’s review. AI cannot primarily rely on group datasets for determinations, and the insurance commissioner can audit practices. Carriers must post prior authorization policy updates on a central location of their website. Most of the law, including the AI provisions, goes into effect in June.
3. North Dakota: While signed in 2025, the legislation went into effect in January. The law says plans must decide on nonurgent prior authorization requests within seven calendar days and urgent care requests within 72 hours. After that, services will just be approved.
4. Nebraska: Nebraska’s law, which also went into effect this year, lays out similar response requirements to that of North Dakota. Beginning in 2028, insurers will have even less time to review urgent requests.
5. Alaska: This law requires payers to inform patients of prior authorization decisions within 72 hours for routine cases or 24 hours for expedited ones. This went into effect in 2026, as well.
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