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Committee considers bill to tighten prior authorization rules and limit AI‑only denials
Summary
SB 53 95 would require timing and transparency for prior authorization decisions, require clinician oversight for medical‑necessity denials aided by AI, and ban retrospective clawbacks of previously authorized care; stakeholders largely supported modernization but differed on details and Medicaid coverage.
The House Health Care and Wellness Committee received a staff briefing and extensive stakeholder testimony Feb. 18 on SB 53 95, a bill to reform prior authorization processes used by carriers and health plans. Committee staff said the bill sets timing and communication requirements, requires carriers to post policy updates in a single online location, compels reporting to regulators, and restricts use of artificial intelligence…
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