HB144

What it does

• Requires insurers to make a decision on standard prior authorization requests within 72 hours of receiving them if submitted by methods other than fax.
• Mandates that standard requests sent by fax be decided within 72 hours, excluding weekends.
• States that expedited or urgent requests must be decided within 24 hours after the insurer receives them.
• Requires insurers to request missing information from providers within one calendar day for expedited requests and three days for standard requests if the initial submission is incomplete.
• Allows insurers up to 14 working days to receive additional information once requested, provided they notify the provider of this deadline.
• States that if an insurer does not respond by the deadline with a denial, approval, or request for more info, the request is automatically considered approved.
• Requires insurers to publish their prior authorization standards on their website in detailed, easily understood language and update clinical criteria at least once a year.
• Sets minimum time periods for how long prior authorization approvals last, including 12 months for chronic conditions if treatment plans do not change.