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House advances bill to speed prior-authorizations for health providers, add 'gold card' and API
Summary
A committee substitute for a prior-authorization reform bill was adopted on the House floor. Sponsors said it creates an expedited 'gold card' for providers who secure 90% prior-authorization approvals and incorporates an API to improve real-time tracking of authorizations.
Lawmakers on the floor advanced a committee substitute to streamline prior authorization for health-care providers, aiming to reduce administrative burdens that sponsors said pull physicians away from patient care.
The lady from Greene, the bill sponsor, said the measure builds on prior legislation and adds a component recommended by the Department of Commerce and Insurance: an API to move prior-authorizations into a more automated, trackable system. The sponsor described a "gold carding" mechanism that exempts providers from prior-authorization requirements during an evaluation period if 90% of their prior-authorization requests are approved.
Several members described the administrative burden on physicians. The sponsor cited testimony that physicians spend about 14 hours a week on prior-authorization paperwork. Supporters said the bill rewards providers who follow best practices and gives payers a look-back window to ensure quality control. The House adopted the committee substitute and ordered it perfected and printed for further action.
