A bill for an act relating to prior authorizations and exemptions by health benefit plans and utilization review organizations.

This bill (HSB 19) requires health plans and review organizations to set strict timelines for processing prior authorization requests: 48 hours for urgent cases and 10 days for non-urgent cases (up to 15 days for complex situations). It also mandates annual reviews to eliminate unnecessary prior authorizations for services routinely approved, ensuring such requirements justify administrative costs. Health plans must implement a pilot program by 2026 exempting qualifying primary care providers from certain authorizations, with details published online about eligibility and covered services. Plans must report annual results, including cost analyses and provider feedback, to the insurance commissioner by 2027. The bill directly affects health plans, providers, and patients by streamlining authorization processes and increasing transparency.