HB1274

House Bill 1274 modifies the Prior Authorization Transparency Act in Arkansas to improve efficiency in the appeals process for healthcare service denials. The bill expands the definition of 'utilization review entity' to include third-party administrators of self-insured healthcare plans that perform prior authorizations. It establishes specific timelines for appealing denied authorizations for both nonurgent and urgent healthcare services, specifically for enrollees receiving treatment for hematology or oncology diagnoses. For nonurgent services, the entity must make an appeal decision within four business days, and for urgent services, within two business days. Additionally, the bill simplifies the administrative burden for healthcare providers by mandating that if a preferred treatment under step therapy is denied, the utilization review entity cannot require the provider to submit a new or revised request for that preferred treatment.