Health plans mandated to disclose prior authorization changes by July 2025

Senate Bill 480, introduced in Indiana on April 15, 2025, aims to streamline the prior authorization process for healthcare providers and improve communication between health plans and participating providers. The bill addresses ongoing concerns regarding the efficiency and transparency of prior authorization requirements, which have been criticized for causing delays in patient care.

Key provisions of Senate Bill 480 include mandates for health plans to notify providers of any new prior authorization requirements within a specified timeframe. Notifications must be sent via electronic or traditional mail and clearly labeled, ensuring that providers are aware of changes. Additionally, health plans are required to post this information on their websites, including the effective date of any new requirements.

The bill also stipulates that healthcare providers must notify health plans of any changes to their contact information within seven days. This provision is intended to facilitate smoother communication and reduce the likelihood of miscommunication regarding prior authorization requests.

Debate surrounding Senate Bill 480 has focused on the balance between regulatory oversight and the operational flexibility of health plans. Supporters argue that the bill will enhance patient care by reducing delays associated with prior authorizations, while opponents express concerns about the potential administrative burden on health plans and the implications for cost management.

The economic implications of the bill could be significant, as improved efficiency in the prior authorization process may lead to reduced healthcare costs and better patient outcomes. However, critics warn that increased regulations could lead to higher operational costs for health plans, which may ultimately be passed on to consumers.

As the bill progresses through the legislative process, stakeholders from various sectors, including healthcare providers, insurers, and patient advocacy groups, are closely monitoring its developments. The outcome of Senate Bill 480 could set a precedent for future healthcare legislation in Indiana, particularly regarding the management of prior authorization processes.