MI SB0247

Requires insurers to implement standardized electronic prior authorization processes by June 1, 2023, using internet webpages or similar electronic systems for all health benefit plans requiring prior authorization.

Establishes timeframes for prior authorization decisions: 9 calendar days for non-urgent requests (through May 31, 2024, then 7 days after), and 72 hours for urgent requests; requests are automatically granted if insurers fail to respond within these timeframes.

Mandates that adverse determinations for non-drug benefits be made by licensed physicians and for prescription drugs be made by licensed pharmacists or physicians, with appeal reviews conducted by different health professionals without financial stakes in the outcome.

Requires insurers to post clinical review criteria, prior authorization requirements, and lists of covered benefits requiring authorization on public websites, with 45-60 days advance notice before implementing new or amended requirements.

Directs insurers to report aggregated prior authorization data to the Department of Insurance by June 1 annually, with the department publishing deidentified trend reports by October 1 each year.