Adds to exsiting law to establish the Idaho Prior Authorization Refom Act.
INSURANCE -- Adds to exsiting law to establish the Idaho Prior Authorization Refom Act.
STATEMENT OF PURPOSE
This legislation establishes the Idaho Prior Authorization Reform Act to improve transparency, consistency, and timeliness in prior authorization processes used by health insurers and utilization review organizations. The bill requires insurers to publicly disclose prior authorization requirements and clinical criteria, implement standardized electronic prior authorization processes, and comply with defined timelines for standard and expedited determinations. The legislation establishes notification and appeal standards, requires appropriately qualified clinical reviewers, sets minimum validity periods for approvals, provides continuity of approvals when coverage changes, and prohibits improper revocation of prior authorizations. The bill further provides enforcement authority to the Department of Insurance, requires annual reporting of prior authorization data, establishes penalties for noncompliance, and addresses fraudulent prior authorization requests. The legislation is intended to reduce administrative burden, improve patient access to medically necessary care, and provide clear standards for prior authorization practices in Idaho.
LATEST ACTION
Reported Printed and Referred to Business
BILL INFO
- Session
- 2026
- Chamber
- house
- Status date
- Feb 9, 2026