SD HB1199

Utilization review organizations and health carriers must submit annual reports to the Division of Insurance detailing approval/denial rates and processing times for both urgent and nonurgent prior authorization requests

Health carriers must annually review all services requiring prior authorization and eliminate requirements for services that are routinely approved at rates demonstrating the requirement does not justify administrative costs

Services with at least 80% approval rates must have prior authorization eliminated unless medical or scientific evidence justifies continuation

Division of Insurance must publish all required reports on its website within 60 days of receipt

Dental services, pharmaceutical services, and prescription drug products are excluded from these requirements