Bill > HB1300

This bill amends the Prior Authorization Transparency Act to enhance healthcare insurance transparency and oversight. The bill creates a new trust fund to collect fines and support education and enforcement efforts related to prior authorization processes. It expands the definition of "healthcare service" to include specific medical coding identifiers and redefines "prior authorization" more comprehensively to include various review processes. The bill requires utilization review entities to publicly disclose their prior authorization requirements, clinical criteria, and restrictions in clear, accessible formats, including detailed lists of services requiring prior authorization and their associated billing codes. Additionally, the bill establishes new requirements for how prior authorizations are issued, including specifying that authorizations should cover entire courses of treatment and be medically reasonable. The legislation also creates a more robust enforcement mechanism, allowing the Insurance Commissioner to investigate and fine healthcare insurers and utilization review entities for non-compliance, with penalties ranging from $1,000 to $5,000 per violation and up to $100,000 for repeated systemic failures. The bill aims to increase transparency, simplify the prior authorization process, and provide clearer guidance for healthcare providers and patients.

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https://arkleg.state.ar.us/Bills/Detail?id=hb1300&ddBienniumSession=2025%2F2025R