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Senate committee backs prior-authorization overhaul aimed at speeding care; bill moves to appropriations
Summary
Senate Bill 480, a multi-part prior-authorization reform, advanced unanimously and was recommitted to the Appropriations Committee. The bill establishes tiered rules for prior authorization by cost, requires peer reviewers with similar credentials, sets time limits, and bars rescinding positive determinations.
The Senate Health Committee voted unanimously to advance Senate Bill 480, a comprehensive measure designed to reduce administrative delay caused by prior authorization and to set firm timelines and review standards.
Senator Johnson, the bill sponsor, told the committee the proposal reflects extensive stakeholder work over the interim and creates a tiered framework: no prior authorization for drugs under $100; streamlined, electronic bedside prior authorization for drugs costing $100–$5,000; and maintained review structures for higher-cost drugs or services above $5,000. The bill also sets an aggressive cap (1 percent) on the proportion of services and providers subject to prior authorization and would require denials to be made…
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