INSURANCE – Adds to existing law to establish the Idaho Prior Authorization Reform Act.

This bill, known as the Idaho Prior Authorization Reform Act, establishes new rules for health insurance companies to streamline the process of approving medical treatments before they are provided. It directly affects health insurance issuers, health care providers, and patients by requiring insurers to create a standardized electronic system for submitting prior authorization requests and limiting how long approvals can take. The legislation ensures that requests are denied only when there is clear evidence that a service is not medically necessary, mandates faster review times for urgent cases, and gives providers the right to appeal adverse decisions. Additionally, the bill exempts certain low-cost services from prior authorization requirements and prohibits insurers from interfering with the doctor-patient relationship by restricting independent medical judgment.