MO HB3010

Prior authorization approvals extended from 45 working days to the lesser of 6 months or treatment length; approvals for chronic/long-term conditions (including chemotherapy) remain valid for 12 months from approval date

Health carriers must implement a standardized prior authorization application programming interface (API) conforming to federal standards by January 1, 2027, replacing proprietary portals and electronic forms

Providers with 90% or higher prior authorization approval rates become exempt from prior authorization requirements for those services, subject to twice-yearly audits

New health carriers must honor prior authorization approvals from previous carriers for at least 180 days after an enrollee's coverage begins

Health carriers must annually report prior authorization statistics including approval/denial rates, average response times, most frequently denied services, and mental health service data; failure to meet statutory deadlines results in automatic authorization of requested services