Bill > HB0076

This bill amends Wyoming's insurance code to require that prior authorization adverse determinations and appeals be made exclusively by Wyoming-licensed health care providers. Currently, these determinations and reviews could be conducted by providers licensed in any U.S. state or territory, but the new legislation restricts this to only providers with a current, unrestricted Wyoming license practicing within their professional scope. The bill specifically changes two sections of Wyoming statute (26-55-104 and 26-55-106) to implement this restriction, which means that health insurers and utilization review entities must now ensure that physicians or other licensed health care professionals making adverse determinations or reviewing appeals must be licensed in Wyoming. The changes will take effect on July 1, 2025, and will apply to prior authorization adverse determinations made or appealed on or after that date, which gives insurance companies and healthcare providers time to adjust to the new requirements.

Health and Social Services

https://www.wyoleg.gov/Legislation/2025/HB0076