From several states advancing legislation to CMS considering reforms, here are seven prior authorization updates Becker’s has reported since April 24:
1. HHS will not enforce mental health parity regulations opposed by some large employers and insurers as it reconsiders parity enforcement more broadly. The rule, finalized under the Biden Administration in September, barred plans from using more restrictive prior authorizations for mental healthcare than other services.
2. Arizona lawmakers passed legislation that mandates health insurers to have a medical director independently review all claims denials based on medical necessity.
3. The North Carolina House of Representatives passed a bill aimed at reforming the prior authorization approval process.
4. Pittsburgh-based Allegheny Health Network is partnering with Humata Health for AI-powered touchless prior authorizations.
5. CMS is considering proposals that would cut the number of procedures that are subject to prior authorization.
6. A package of California bills aiming to streamline the prior authorization process passed out of Senate and Assembly health committees.
7. North Dakota Gov. Kelly Armstrong signed a bill requiring insurance plans to provide a decision within seven calendar days for nonurgent prior authorization requests and within 72 hours for urgent care requests.
