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Senate orders third reading of H.31 to clarify claims-edit and prior-authorization rules
Summary
The Senate ordered a third reading of H.31, a House bill that clarifies prior-authorization and claims-edit language from a prior law, including exemptions for out-of-state services, a revised definition of primary care provider, and a delayed effective date for one provision.
The Senate on a voice vote ordered a third reading of H.31, an act clarifying claims-edit standards and prior-authorization requirements that were first enacted last spring as part of Act 111. Senator Lyons, reporting the bill, said the changes align statutory language with payer and provider practices.
Senator Lyons told the Senate the bill makes three primary clarifications intended to reduce confusion between payers and providers and to implement the prior-authorization reforms adopted in Act 111. Lyons said stakeholders including the Vermont Medical Society, Blue Cross and Blue Shield, the Hospital…
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