Indiana House Bill 1610 (Prior Session Legislation)

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Spectrum: Slight Partisan Bill (Republican 3-1)
Status: Introduced on January 19 2023 - 25% progression, died in committee
Action: 2023-01-19 - First reading: referred to Committee on Insurance
Pending: House Insurance Committee
Text: Latest bill text (Introduced) [PDF]

Exemption from prior authorization requirements. 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.

Exemption from prior authorization requirements.

Rep. Rita Fleming [D]

Rep. Dennis Zent [R]

Rep. Ann Vermilion [R]

Rep. Bradford Barrett [R]

Date	Chamber	Action
2023-01-19	House	First reading: referred to Committee on Insurance
2023-01-19	House	Authored by Representative Fleming
2023-01-19	House	Coauthored by Representatives Zent, Vermilion, Barrett

Type	Source
Summary	https://iga.in.gov/legislative/2023/bills/house/1610/details
Text	https://iga.in.gov/legislative/2023/bills/house/1610/#1.INTR