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Senate committee backs prior-authorization bill with amendments after wide stakeholder debate
Summary
The Senate Committee on Health and Human Services voted to pass HB 250 with amendments after testimony from insurers, providers and patient advocates; the committee removed certain definitions and moved to align the measure with a related working-group provision in SB 1449.
The Senate Committee on Health and Human Services voted to pass HB 250, a bill on prior authorization practices, approving amendments intended to narrow certain definitions and refer technical work to an existing statutory vehicle.
The committee’s action follows more than an hour of testimony from insurers, provider groups and patient advocates who debated timelines, reporting and pharmacy coverage. Committee chair and members said they would remove the bill’s healthcare definition at the Attorney General’s request and incorporate Kaiser Permanente’s suggested change to use the working group language found in SB 1449.
The changes the committee announced aim to create a reporting mechanism and a nonbinding working group to develop standards for automating prior authorization. Sam Mendoza, speaking for the stakeholder group that drafted a revised version, described the bill as a compromise that “bring[s] together” reporting to the planning agency and a working group to pursue automation while removing clauses inconsistent with the agency’s statutory definitions.
Insurers raised concerns about specific sections. Tonia Neal of the Pharmaceutical Care Management Association said the bill’s pharmacy provisions would duplicate existing pharmacy prior-authorization processes and could slow emergency approvals. Dawn Kurisu of HMSA asked that language on pages cited in testimony be removed and thanked stakeholders for trying to reach workable language. Jonathan Ching of Kaiser Permanente urged alignment with evolving federal requirements so state reporting does not duplicate federal obligations.
Patient and provider witnesses urged timeliness and transparency. James Lopey described a canceled procedure he said resulted from prior-authorization delays and urged a 48-hour timeline; advocates and physician groups urged caution about strict timelines that might increase costs or conflict with federal rules.
In closing remarks the chair noted concerns that short statutory timelines could increase unfunded liabilities for certain public employer health plans and said the committee expects the working group to recommend reasonable timelines.
The committee report directs amendments and records the committee’s intent to adopt the working-group approach in SB 1449, remove the challenged definition, and proceed with a reported measure that includes the technical changes discussed at the hearing.
