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Committee delays peer-to-peer review change in insurance data bill pending department hearing
Summary
The committee held House Bill 297 — which would give self-funded plans access to claims data and extend doctors’ ability to conduct peer-to-peer reviews during the appeal process — and agreed to schedule a hearing with the insurance department to resolve concerns about specialty matching and scope.
The Senate Commerce Committee postponed final action on House Bill 297 after members questioned an amendment that would lengthen the window for physician-to-plan peer-to-peer conversations during claim review and appeals.
Senator Mcu, the sponsor on the floor, explained the bill would require self-funded plans to provide their plan sponsors access to claims data — addressing situations where third-party administrators treat data as proprietary — and the amendment would ensure patients’ physicians can engage in peer-to-peer reviews even after an appeal has been initiated. Senator Mcu said the change is intended to reduce delays in care by preserving clinicians’ ability to speak to plan reviewers and that the amendment does not mandate coverage determinations.
Committee members raised procedural and substantive concerns. Senator Rashard asked whether the insurance commissioner had been consulted; Senator Mcu said the department had been contacted and that related work was ongoing in the other legislative body. Senator Re argued the peer-to-peer amendment differs materially from the bill’s data-access purpose, expressed discomfort that the committee had not held a public hearing on that topic, and criticized unclear language about matching physician specialties.
After discussion the chair proposed scheduling a committee hearing to bring the insurance department and stakeholders in to clarify definitions and timing. Senators agreed to withdraw a pending 'ought to pass' motion to allow staff to schedule that additional review; the transcript also notes the bill’s fiscal note was zero. The committee did not record a final roll-call vote on HB 297; the matter was held for future consideration.
Next steps: staff will schedule a hearing with the insurance department and interested parties to address specialty-matching language and other technical concerns before the committee considers the amendment further.
