Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Prior Authorization Reform topic
No spam. Unsubscribe anytime.
Senate committee considers prior-authorization reform; bill pulled aside for further review
Summary
Assembly Bill 463 would shorten prior-authorization timelines for insurers and Medicaid and exempt certain routine preventive treatments from prior authorization; the Senate committee heard broad support from medical groups but pulled the bill aside for technical review.
Assembly Bill 463 seeks to reform prior-authorization procedures for insurers and Medicaid, including shorter turnaround times and a list of preventive treatments that would not require prior authorization, Assemblymember Shay Backus told the Senate Committee on Health and Human Services.
"Prior authorization reform is the number 1 priority for us and our patients," Jacqueline Winn of the Nevada State Medical Association told the committee. She said Nevada’s current prior-authorization timeline (reported in testimony as 20 days) creates delays and administrative burdens; the bill’s reprint would reduce nonurgent turnaround to two business days (or CAQH/CAQH-aligned timelines) and set a hard seven-calendar-day maximum in some cases.
Multiple medical groups testified in support. Leah Cartwright of the Nevada Psychiatric Association described cases reviewed by the state’s child death review process in which denials or delays in coverage were associated with subsequent deaths; she urged the committee to act. Obstetricians and primary-care physicians described routine denials for common tests and supplies such as diabetic test strips, anatomy scans and some imaging, and urged faster responses.
Neutral testimony flagged statutory exemptions for certain entities. Adam Plain of the Nevada Division of Insurance explained that some nonprofit hospital corporations (NRS 695B) and HMOs licensed under NRS 695C may be exempt from parts of the insurance code unless explicitly drawn in; he recommended reviewing NRS provisions that define covered health carriers. Committee counsel and the Division later debated whether the bill’s definition of "health carrier" (NRS 695.024) already includes HMOs; counsel said the statutory definition references HMOs and therefore could cover them.
The Nevada Association of Health Plans said in neutral testimony it was generally supportive of shortening turnaround times but cautioned about aligning deadlines with CMS guidance and noted concerns about operational feasibility.
At the end of the hearing, the chair said he would pull AB463 aside to double-check statutory coverage and technical language; AB463 was not included in the committee’s due-pass consent motion and no committee vote on final passage was recorded.
