Senate hears S.B. 319 to speed and increase transparency in prior authorization reviews
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Summary
Senator Johnson presented S.B. 319, requiring insurers to publish prior-authorization criteria, disclose AI use, and meet decision timelines (5 business days standard, 72 hours urgent); bill seeks independent medical reviewers for adverse determinations and longer authorization periods for chronic care.
Senator Johnson presented S.B. 319 on the Senate floor, framing it as a targeted reform to improve transparency, accountability and timeliness in health-insurance prior authorization without eliminating utilization review.
Johnson said the bill requires insurers to publish all prior-authorization requirements on their websites in clear language, update them when they change, and disclose whether artificial intelligence is used in review processes. "This bill...does not eliminate prior authorizations. It disciplines it," Johnson said, adding that insurers must decide standard requests within five business days and urgent requests within 72 hours.
Sponsor Johnson also said adverse determinations tied to clinical necessity must involve appropriately licensed, independent medical judgment and not rely solely on recommendations from another source. For chronic conditions, authorizations generally must last at least 12 months; outpatient services not less than six months, with flexibility where therapies change.
Senator Johnson told the Senate he supports disclosure of AI use but favors a human-in-the-loop approach rather than an outright ban.
The sponsor moved third reading and the Senate began roll-call procedures.