Introduced House Bill (H)

Authored by

DIGEST

Health insurance coverage and cost information. Requires health care providers and health plans to provide to covered individuals and patients certain information concerning the cost of health care services. Requires health care providers to publish a payment policy for medically necessary health care services not covered by a third party payment source. Requires the department of insurance to establish, post, and maintain on the department's Internet web site a standardized prior authorization form for notice or authorization for health care services. Requires a state employee health plan, an accident and sickness insurer, and a health maintenance organization to: (1) use Health insurance coverage and cost information. Requires health care providers and health plans to provide to covered individuals and patients certain information concerning the cost of health care services. Requires health care providers to publish a payment policy for medically necessary health care services not covered by a third party payment source. Requires the department of insurance to establish, post, and maintain on the department's Internet web site a standardized prior authorization form for notice or authorization for health care services. Requires a state employee health plan, an accident and sickness insurer, and a health maintenance organization to: (1) use only the standardized prior authorization form; (2) allow electronic submission of the form and supporting information; and (3) respond verbally and electronically within 48 hours. Prohibits Medicaid, including risk based managed care organizations, from requiring prior authorization for certain drug testing of recipients enrolled in a drug treatment program. Urges the legislative council to assign issues related to health care prior authorization to an appropriate interim study committee for study and a report during the 2017 interim of the general assembly. ... View more