Tyler Johnson
- Republican
- Senator
- District 14
Author
Provides that a utilization review entity may only impose prior authorization requirements on less than 1% of any given specialty or health care service and 1% of health care providers overall in a calendar year. Prohibits a utilization review entity from requiring prior authorization for: (1) a health care service that is part of the usual and customary standard of care; (2) a prescription drug that is approved by the federal Food and Drug Administration; (3) medication for opioid use disorder; (4) pre-hospital transportation; or (5) the provision of an emergency health care service. Sets forth requirements for a utilization review entity that requires prior authorization of a health care service. Provides that all adverse determinations and appeals must be reviewed by a physician who meets certain conditions. Requires a utilization review entity to provide an exemption from prior authorization requirements if in the most recent 12 month period the utilization review entity has approved or would have approved at least 80% of the prior authorization requests submitted by the health care provider for a particular health care service. Repeals superseded provisions regarding prior authorization. Makes corresponding changes.
No votes to display
Senator Randolph added as coauthor
Senators Buck and Zay added as coauthors
Senator Niezgodski added as coauthor
Senator Donato added as coauthor
Committee report: do pass, adopted
Pursuant to Senate Rule 68(b); reassigned to Committee on Appropriations
Senators Alting and Doriot added as coauthors
Senator Ford J.D. added as coauthor
Senator Yoder added as coauthor
Senators Busch and Koch added as coauthors
Senator Crider added as coauthor
Senator Leising added as coauthor
Senators Walker K and Alexander added as coauthors
First reading: referred to Committee on Health and Provider Services
Authored by Senator Johnson T
Senator Charbonneau added as second author
Senator Garten added as third author
Senators Brown L and Rogers added as coauthors
Senators Baldwin and Messmer added as coauthors
Senator Becker added as coauthor
Senator Bohacek added as coauthor
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