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SB897 • 2026

Enacts provisions relating to prior authorization of health care services

Enacts provisions relating to prior authorization of health care services

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Brown (26), Ben; House handler: N/A
Last action
2026-03-03
Official status
Hearing Conducted S Insurance and Banking Committee
Effective date
2026-08-28

Plain English Breakdown

The plain English breakdown is still being put together. The official documents below are already here.

Bill History

  1. 2026-03-03 Missouri House of Representatives and Missouri Senate

    Hearing Conducted S Insurance and Banking Committee

  2. 2026-01-08 S126

    Second Read and Referred S Insurance and Banking Committee

  3. 2026-01-07 S41

    S First Read

  4. 2025-12-01 Missouri House of Representatives and Missouri Senate

    Prefiled

Official Summary Text

The following summaries of this bill are available:

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Introduced

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SB 897 - This act provides that health care providers shall not be required to obtain prior authorization for a health care service unless the health carrier or utilization review entity determines that in the most recent evaluation period, as defined in the act, less than 90% of the prior authorization requests submitted by that provider for that health care service were approved or would have been approved.

Additionally, health care providers shall not be required to obtain prior authorization for any health care services unless the health carrier or utilization review entity has approved or would have approved less than 90% of all prior authorization requests submitted by that provider for health care services.

Health carriers and utilization review entities shall notify providers within 25 days after a determination is made under the act, shall include in the notification certain information used in making the determination, shall establish an appeals process for the providers, and shall maintain an online prior authorization portal as described in the act.

No health carrier or utilization review entity shall deny or reduce payment to a health care provider for a health care service for which the provider has prior authorization, except as described in the act.

This act shall not apply to MO HealthNet services not provided through a managed care organization, or to providers who have not participated in a health benefit plan offered by the health carrier for at least one full evaluation period.

This act is substantially similar to HB 618 (2025) and to provisions in HCS/SB 94 (2025), and is similar to SB 230 (2025), SB 983 (2024), HB 1976 (2024), SB 576 (2023), and HB 1045 (2023).
TAYLOR MIDDLETON