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Committee advances bill to shorten utilization-review decision window to 72 hours; senators press insurers' prior-authorization practices
Summary
S.9651 would require utilization-review determinations within 72 hours (including weekends/holidays) and set clinical-criteria standards; Senator May pressed whether the bill would reduce prior-authorization frequency and the chair said it tightens review timelines but does not itself change what triggers authorizations.
The committee advanced S.9651, a measure to amend public health and insurance law to set standards for utilization review and require that decisions be made within 72 hours (measured as hours, not business days), a change from the existing "three business days" standard.
Senator May raised concerns that prior authorization is being used more broadly than intended, asking whether the bill would reduce the instances in which insurers require prior authorization. "I've heard from health practitioners that prior authorization is being used way more than it be used to," May said. The chair responded that S.9651 focuses on the timing and clinical-criteria standards for utilization-review decisions — for example, shortening the decision window to 72 hours — but does not itself alter how often prior authorization is required.
The committee moved the bill and advanced it to first reading. The transcript does not record a roll-call or a detailed fiscal analysis on the record. Implementation details such as enforcement mechanisms, appeals processes and any effects on insurer behavior will depend on rulemaking and later stages of the legislative process.
