Committee hears mixed views on prior authorization changes, a $25,000 'high‑dollar' threshold and a 1332 reinsurance authorization
Witnesses and regulators debated changes to utilization management — including a $25,000 numeric definition for 'high‑dollar' claims and narrowing of primary‑care prior‑authorization exemptions — and authorized agencies to apply for a Section 1332 reinsurance waiver to potentially lower premiums with federal pass‑through funding.
The full story
Lawmakers considered several utilization‑management changes and a reinsurance authorization at Thursday’s hearing, with insurers, providers and state officials outlining tradeoffs between controlling costs, reducing administrative burdens and protecting insurers’ solvency.
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