IA HSB19

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

Organizations must provide health care providers a receipt acknowledging prior authorization requests within 24 hours of submission

Utilization review organizations must annually review all services requiring prior authorization and eliminate requirements for services that are routinely approved at rates that don't justify the administrative costs

Complaints about utilization review organization compliance may be filed with the insurance division, which must notify the organization; complaints are not considered public records

Health carriers must implement a pilot prior authorization exemption program by January 15, 2026, exempting certain providers (including primary care providers) from some authorization requirements, and submit a report on results to the insurance commissioner by January 15, 2027