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Committee weighs prior‑authorization overhaul that limits AI‑only denials
Summary
The Health Care and Wellness Committee heard testimony on SB 5395, which would tighten timelines and require clinician oversight of prior‑authorization denials, limit standalone AI decisions, and require carriers to publish changes and report AI‑aided denial rates beginning in 2027.
The Health Care and Wellness Committee on Feb. 18 considered Senate Bill 53‑95, a measure to reform prior‑authorization practices used by health carriers and plans. Committee staff said the bill sets timing requirements for decisions, requires carriers to post policy changes in a single online location and to include the provider who had clinical oversight when issuing a denial.
"AI may not be the sole means used to deny, delay, or modify healthcare services," committee staff told…
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