Loading chat...
IN HB1486
Bill
Status
1/18/2017
Primary Sponsor
Donna Schaibley
Click for details
AI Summary
HB 1486 Summary
-
State employee health plans, accident and sickness insurers, and health maintenance organizations must use a standardized prior authorization form established by the Department of Insurance and respond to authorization requests within 48 hours using both verbal and electronic communication.
-
Health care providers and practitioners must provide patients without third-party coverage a good faith estimate of out-of-pocket costs within 72 hours of request, and must provide billing information to patients with insurance within 72 hours to enable their insurers to estimate costs.
-
Provider facilities and practitioners must publish their payment policies for medically necessary services not covered by insurance on their websites or in visible locations, with those meeting federal 501(r) requirements considered compliant.
-
Medicaid, including risk-based managed care organizations, is prohibited from requiring prior authorization for definitive drug testing of recipients enrolled in substance abuse treatment programs.
-
Effective July 1, 2017; the legislative council is urged to study prior authorization effects and changes from 2007-2017, with recommendations due by November 1, 2017.
Legislative Description
Health insurance coverage and cost information. Requires health care providers and health plans to provide to covered individuals and patients certain information concerning the cost of health care services. Requires health care providers to publish a payment policy for medically necessary health care services not covered by a third party payment source. Requires the department of insurance to establish, post, and maintain on the department's Internet web site a standardized prior authorization form for notice or authorization for health care services. Requires a state employee health plan, an accident and sickness insurer, and a health maintenance organization to: (1) use
Last Action
First reading: referred to Committee on Insurance
1/18/2017