NE LB77

Requires utilization review agents to post prior authorization requirements and clinical review criteria on their websites, with searchable format required by July 1, 2027, and mandates 60 days notice to providers before implementing new requirements

Establishes decision timeframes for prior authorization requests: 72 hours (48 hours after January 1, 2028) for urgent care and 7 days for non-urgent care, with services deemed authorized if deadlines are missed

Requires all prior authorization denials to be made by a physician or clinical peer, prohibits AI algorithms as the sole basis for denying care based on medical necessity, and bans compensation tied to denial volume

Creates uniform prior authorization request forms (maximum 2 pages) to be approved by the Department of Insurance by November 1, 2025, with mandatory use beginning January 1, 2026

Mandates insurance and Medicaid coverage of biomarker testing beginning January 1, 2028 for cancer, autoimmune diseases, Parkinson's, ALS, Alzheimer's, organ transplants, and pharmacogenomic testing when supported by clinical utility evidence