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JBC questions legal and practical basis for reinstating prior authorization in behavioral health
Summary
Staff recommended mixed actions on behavioral‑health supplemental requests: approve a portion of incentive reductions but not to endorse outpatient psychotherapy prior‑authorization (PAR) implementation because OLS advised it may conflict with statute. Committee asked for further options and data on utilization and administrative burden.
The JBC spent a substantial portion of the session on a package of HCPCS behavioral‑health requests that included a forecast increase, incentive payment reductions and a proposed return of prior authorization rules for outpatient psychotherapy.
Emily Pope, JBC staff, outlined a behavioral‑health forecast increase of about $18.5 million in general fund and a range of rate and payment requests. On the incentive payments (S6.02), staff recommended approving a modest reduction (about half of the department’s requested $3 million) because cutting incentives may be preferable to cutting direct services. On outpatient psychotherapy prior authorizations (PARs, S6.09), staff and nonpartisan legal staff (OLS) flagged a legal problem: while an executive order can limit appropriations, it cannot authorize the Executive Branch to implement actions that are prohibited by statute. Pope said OLS considered directing non‑state actors to violate state law especially problematic.
Representative Brown told the committee she was “willing to talk with the department about the needs related to utilization management” but supported staff’s recommendation to avoid implementing PARs without clear statutory authority. Senator Mobley and other members expressed concern that returning to PARs could increase administrative burden and potentially drive costs higher by shifting care patterns; they asked for better evidence of misuse before endorsing prior authorization.
The committee approved staff recommendations on several HCPCS items, denied or postponed actions tied to statutory questions, and requested more data from the department on administrative percentages, utilization patterns and the downstream effects of incentive and PAR changes before figure setting.
