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Panel considers expanding peer-to-peer reviews so doctors can advocate for patients throughout prior-authorization process
Summary
Lawmakers debated HB1554, which would let providers request peer-to-peer clinical conversations at any stage of prior authorization. Supporters said it closes a gap that pushes patients into appeals; insurers warned it could slow appeals or expose reviewer details.
The House Insurance Subcommittee spent an extended session on HB1554, a bill that would allow an insured or their provider to request a peer-to-peer clinical conversation at any stage of a prior-authorization review — including after an initial denial but before external review — and clarifies credentialing requirements for the carrier reviewer.
Sponsor testimony highlighted real-world instances where an authorization is denied within minutes and the treating clinician loses the opportunity to speak with a reviewer. "So your doctor needs the opportunity to talk to the doctor at the plan for the duration of the first process," the…
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