IA HF303

Utilization review organizations must respond to prior authorization requests within 48 hours for urgent requests, 10 calendar days for nonurgent requests, and 15 calendar days for complex or high-volume situations

Organizations must notify health care providers of receipt of prior authorization requests within 24 hours of submission

Requires annual reporting to the insurance commissioner on prior authorization data, including approval/denial rates, response times, and statistics for both urgent and nonurgent requests, to be published on a publicly accessible website within 60 days

Mandates annual review of all services requiring prior authorization, with elimination of requirements for services routinely approved at high rates that do not sufficiently justify administrative costs to promote health care quality or reduce spending

Complaints about utilization review organization compliance may be directed to the insurance division, which must notify organizations of complaints; complaint records are not considered public records