H1136
An Act improving the health insurance prior authorization process
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- Passed House
- Passed Senate
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- Became Law
Bill overview
This bill aims to streamline and improve the process for health insurance companies to require prior authorization for certain medical treatments and medications. Currently, the process can be lengthy and confusing for both patients and providers. The bill seeks to increase transparency and reduce delays in obtaining these authorizations, ultimately improving access to necessary care. It intends to create a more efficient and predictable system for prior authorization requests.
Key provisions
- Requires health insurers to provide clear and standardized prior authorization requirements.
- Establishes timelines for insurers to respond to prior authorization requests.
- Mandates that insurers notify providers and patients promptly about prior authorization decisions.
- Creates a process for patients to appeal prior authorization denials.
- Requires insurers to provide data on prior authorization approval and denial rates.
Who is affected
- Patients
- Healthcare Providers
- Health Insurance Companies
- Medicaid Managed Care Organizations
- Pharmaceutical Companies
Notable changes
- The bill seeks to reduce the time it takes to obtain prior authorizations.
- It aims to improve communication between patients, providers, and insurers regarding prior authorization requests.
- The bill could lead to increased transparency in the prior authorization process.
Sponsors
Official sponsors from legislative records.
Primary sponsor
Marjorie C. Decker
Cosponsors
Adam J. Scanlon
Amy Mah Sangiolo
Carmine Lawrence Gentile
Danillo A. Sena
Arguments in favor
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Bill H.1136 194th (Current)
An Act improving the health insurance prior authorization process
By Representative Decker of Cambridge, a petition (accompanied by bill, House, No. 1136) of Marjorie C. Decker and others relative to the health insurance prior authorization process. Financial Services.
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Bill Information
Bill Information
Presenter: Marjorie C. Decker
Tabs
Bill History Petitioners Committee Summary Hearing Attendance
Bill History
Displaying 5 actions for Bill H.1136
| Date | Branch | Action |
| 2/27/2025 | House | Referred to the committee on Financial Services |
| 2/27/2025 | Senate | Senate concurred |
| 7/3/2025 | Joint | Hearing scheduled for 07/15/2025 from 10:00 AM-01:00 PM in A-2 |
| 10/20/2025 | Joint | Hearing scheduled for 07/15/2025 from 10:00 AM-01:00 PM in A-2 |
| 10/20/2025 | House | Accompanied a new draft, see H4616 |
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