Exemption from prior authorization requirements.
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HB 1610 — Exemption from prior authorization requirements.
Last action — First reading: referred to Committee on Insurance
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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2In Committee
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3Passed House
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4Passed Senate
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5To Executive
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6Enacted
This bill died with 2023 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.
Summary
Amends the law concerning the prior authorization of health care services by a health plan (which includes a policy of accident and sickness insurance, a health maintenance organization contract, and the Medicaid risk based managed care program). Provides that: (1) if a health plan, during a six month evaluation period, approves at least 90% of a health care provider's requests for prior authorization for a particular type of health care service, the health plan may not require the health care provider to obtain prior authorization for that type of health care service for the entire duration of an exemption period of six calendar months immediately following the evaluation period; and (2) at the conclusion of the initial exemption period, the health plan shall continue granting consecutive exemption periods of six months to the health care provider unless the health plan rescinds the exemption. Provides that a health plan may rescind a health care provider's exemption only on the basis of a determination by a physician that, in at least five and not more than 20 cases randomly selected for review, less than 90% of the health care services provided by the health care provider met the health plan's medical necessity criteria. Authorizes a health care provider that is notified of the rescission of its exemption to initiate a review of the rescission by an independent review panel. Requires the independent review panel to determine whether at least 90% of the health care services provided by the health care provider met the health plan's medical necessity criteria. Requires a health plan to restore the health care provider's exemption if the independent review panel's determination is in favor of the health care provider. Requires the insurance commissioner to adopt rules.
Bill Text
We don't have the full text on file for this bill yet.
Read HB 1610 on the official Indiana source →Action History
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First reading: referred to Committee on Insurance
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Authored by Representative Fleming
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Coauthored by Representatives Zent, Vermilion, Barrett
Sponsors
- Brad Barrett · Cosponsor
- Ann Vermilion · Cosponsor
- Dennis Zent · Cosponsor
- Rita Fleming · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 3 co-sponsors · 146 not signed on
Sponsors (1)
- Rita Fleming
Co-sponsors (3)
- Brad Barrett Republican
- Ann Vermilion
- Dennis Zent
Not signed on (146)
146 members have not signed on to this bill.
Show all 146 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- What does HB 1610 do?
- Amends the law concerning the prior authorization of health care services by a health plan (which includes a policy of accident and sickness insurance, a health maintenance organization contract, and the Medicaid risk based managed care program). Provides that: (1) if a health plan, during a six month evaluation period, approves at least 90% of a health care provider's requests for prior authorization for a particular type of health care service, the health plan may not require the health care provider to obtain prior authorization for that type of health care service for the entire duration of an exemption period of six calendar months immediately following the evaluation period; and (2) at the conclusion of the initial exemption period, the health plan shall continue granting consecutive exemption periods of six months to the health care provider unless the health plan rescinds the exemption. Provides that a health plan may rescind a health care provider's exemption only on the basis of a determination by a physician that, in at least five and not more than 20 cases randomly selected for review, less than 90% of the health care services provided by the health care provider met the health plan's medical necessity criteria. Authorizes a health care provider that is notified of the rescission of its exemption to initiate a review of the rescission by an independent review panel. Requires the independent review panel to determine whether at least 90% of the health care services provided by the health care provider met the health plan's medical necessity criteria. Requires a health plan to restore the health care provider's exemption if the independent review panel's determination is in favor of the health care provider. Requires the insurance commissioner to adopt rules.
- Who sponsors HB 1610?
- HB 1610 is sponsored by Brad Barrett (Republican), Ann Vermilion, Dennis Zent, and Rita Fleming.
- What is the current status of HB 1610?
- This bill died with 2023 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
- Where can I track HB 1610?
- Track HB 1610 free on One Click Politics — get push/email alerts when it moves.
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