Prior Authorization Bill Becomes Law Without Governor’s Signature
Photo Credit: Ceoffman | Dreamstime
A bill adding requirements for insurers to streamline the prior authorization process for healthcare providers and patients became law without Governor Mike Dunleavy’s signature. However, even as the bill was pending on the governor’s desk, a major insurer announced it would take steps on its own.
Time Frames and Directions
The standards for prior authorization of medical care and prescription drugs in Senate Bill 133 include time frames for approvals and directions that must be followed if the insurer makes an adverse determination or doesn’t receive enough information to make a determination. It also sets a length of time that a prior authorization may be granted for a chronic condition.
The Alaska Hospital and Healthcare Association supported the bill, stating, “We hear story after story about time-consuming appeals, endless paperwork, lack of consistency and transparency, and needless interruptions to treatment when patients are at their most vulnerable. This has contributed to a contentious relationship between providers and insurers in Alaska and across the country.”
Stakeholders came together to craft provisions of SB133, which was introduced by the Senate Labor and Commerce Committee in March. Senators passed the bill in May with no votes against it, and it passed the Alaska House of Representatives unanimously the following week. The governor had sixty days to consider the bill, and it became law without his signature on July 15.
In late June, Premera Blue Cross announced its own prior authorization improvements. The insurer says it’s committing to provide near real-time responses for at least 80 percent of electronic prior authorization requests by 2027, provided that all necessary clinical documentation is included. All prior authorization requests that can’t be automatically approved will continue to be reviewed by licensed, qualified clinicians guided by national best practices. Policyholders will receive information about what’s needed for prior authorization, next steps, and how to appeal if necessary.
Premera stated, “These changes are part of a broader, voluntary commitment by [Blue Cross Blue Shield] companies to improve the healthcare experience for everyone. At Premera, we’re proud to lead the way in creating a more efficient, affordable, and sustainable system.”
Premera Blue Cross Blue Shield of Alaska serves about 163,000 members in the state.