ID H0611

Establishes the Idaho Prior Authorization Reform Act requiring health insurers to maintain and publicly disclose all prior authorization requirements, clinical review criteria, and approval/denial statistics on their websites by July 1, 2026

Sets response deadlines of 5 calendar days for standard prior authorization requests, 2 business days for pharmaceutical requests, and 24 hours for expedited/urgent requests

Requires prior authorization approvals to remain valid for 12 months (or length of treatment for chronic conditions), and mandates new insurers honor previous approvals for at least 90 days when enrollees switch plans

Mandates standardized electronic prior authorization systems by July 1, 2026, with all providers required to use electronic submission by January 1, 2027

Authorizes the Idaho Department of Insurance to enforce compliance through cease-and-desist orders and administrative fines up to $10,000 per violation, with automatic approval of services if insurers fail to meet required deadlines