ID H0841

Establishes the Idaho Prior Authorization Reform Act requiring health insurers to decide standard prior authorization requests within 7 calendar days and expedited/urgent requests within 72 hours of receiving complete documentation.

Requires insurers to maintain publicly accessible lists of services requiring prior authorization, post clinical review criteria on their websites, and provide 60 days advance notice before implementing new or amended prior authorization requirements.

Mandates prior authorization approvals remain valid for 6 months (or 12 months for chronic/long-term conditions), and requires new insurers to honor existing approvals for at least 90 days when enrollees change plans.

Requires insurers to implement electronic prior authorization systems conforming to federal CMS interoperability standards by January 1, 2027, and submit annual reports to the Department of Insurance on approval/denial rates and most frequently denied services.

Authorizes the Department of Insurance to impose administrative fines up to $10,000 per violation for non-compliance, but explicitly excludes any private right of action; exempts insurers requiring prior authorization on less than 1% of claims.