Missouri committee hears bill to 'gold‑card' high‑performing providers and curb prior‑authorization burden

Summary

Lawmakers, hospitals and providers debated House Bill 618, which would exempt providers or organizations with high prior‑authorization approval rates from future prior‑authorization requirements. Supporters say it would speed care and cut administrative costs; insurers warn it could raise costs and remove needed safeguards.

The Missouri House Insurance Committee on Wednesday heard testimony on House Bill 618, a proposal to create a “gold carding” system that would exempt providers or provider organizations from certain prior‑authorization requirements if they meet a high approval threshold.

Representative Melanie Stinnett, the bill sponsor, told the committee the bill “creates what we call a gold carding system for prior authorization” and would not eliminate prior authorization but would exempt providers or organizations that “achieve at least 90% authorization approval” during an evaluation period.

The bill’s proponents — including hospitals, physicians and nurses — said prior authorization causes delays and administrative burdens that can harm patients and drive up costs. Andrew Wheeler of the Missouri Hospital Association told the committee that “the problem is that this healthy friction has become unhealthy,” and cited a national report showing millions of prior‑authorization requests for Medicare Advantage plans as evidence the system consumes substantial clinician and hospital time.

Physicians gave multiple…

Missouri committee hears bill to 'gold‑card' high‑performing providers and curb prior‑authorization burden

Summary

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