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Montana committee hears testimony for SB 446 to tighten prior-authorization reviews; insurers warn of costs
Summary
SB 446 would require appropriately specialized reviewers for prior-authorization denials and included a 'deeming' clause that would approve care automatically if insurers fail review timelines; health providers urged swift passage while major insurers cautioned the measure undoes months of negotiated compromise and could raise premiums. The committee adopted coordination language with House bills and removed the automatic 'deeming' section before concurring on the bill as amended.
Sen. Vince Ricci, sponsor of Senate Bill 446, told the House Business and Labor Committee he drafted the measure after hospital site visits and discussions with clinicians who told him prior-authorization processes were delaying care. “If an insurer does not comply with the requirements, either the timeline or appropriate reviewer, then the patient gets that service. It's considered approved,” Ricci said, explaining the bill’s original deeming provision.
Proponents, including pediatric nurse practitioner Kim Longcake of Logan Health Billings Clinic, described repeated examples of delayed or rejected requests that lacked specialty expertise on the reviewing side. “If they're going to say no we just need to make sure that it's an appropriate…
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