Relating to health carriers and payment of claims, audits, and standards of conduct; prior authorizations and utilization review organizations; and providing civil penalties and including applicability provisions

Amendments · 4

3 adopted · 0 failed · 1 never voted on. Newest first.

• H-8154 · filed March 4, 2026 by

  AI summary This amendment adds a definition for "downgrade" regarding medical service requests and allows doctors to choose to receive audit notices electronically. It also requires healthcare providers to submit prior authorization requests electronically starting July 1, 2027, and updates the information required about clinical reviewers. Its wording →
  Never voted on
• S-5067 · filed March 4, 2026 by Sen. Kara Warme (R)

  AI summary This amendment adds a definition for "downgrade" regarding medical authorization requests and allows doctors to choose to receive audit notices electronically. It also requires healthcare providers to submit prior authorization requests electronically starting July 1, 2027, and updates the information required about clinical reviewers to include their board certifications and expertise. Its wording →
  Adopted
  March 4, 2026
• S-5060Strike everything · filed March 4, 2026 by Sen. Kara Warme (R)

  AI summary This amendment replaces the entire bill and establishes new rules for health insurance companies and review organizations. It prohibits using artificial intelligence as the only reason to deny or delay a medical request, sets specific deadlines and appeal processes for claim audits, and prevents insurance companies from penalizing doctors for their staffing or referral decisions. It also requires that any denial or downgrade of a medical request be made by a qualified professional in a similar medical specialty and accompanied by a written explanation. Its wording →

  Amends this SF 2421 to CONFORM to HF 2635
  Adopted
  March 4, 2026
• H-8080Strike everything · filed March 3, 2026 by

  AI summary This amendment replaces the entire bill. It prohibits insurance companies from using artificial intelligence as the only reason to deny or delay medical care, sets specific timelines and appeal processes for medical audits, and prevents insurers from penalizing doctors for their staffing or out-of-network referrals. It also requires that any denial or downgrade of a prior authorization request be made by a qualified professional in a similar medical specialty and accompanied by a written explanation. Its wording →
  Adopted
  March 3, 2026