HB1300

House Bill 1300 amends the Prior Authorization Transparency Act to increase administrative requirements for utilization review entities and health insurers. It establishes a 'Prior Authorization Transparency Act Trust Fund' to finance compliance monitoring and enforcement by the State Insurance Department. The bill broadens the definition of prior authorization and requires insurers to publish detailed clinical criteria, statistics on approvals and denials, and clear disclosure of any coverage restrictions on their websites. It mandates that insurers provide at least 60 days' notice to healthcare providers before implementing new or amended prior authorization requirements. Furthermore, it creates new protections for providers by limiting the circumstances under which a previously authorized claim can be denied. The bill also introduces a transition provision requiring payment for certain ongoing treatments during the first 60 days of a patient's new health insurance coverage, even without prior authorization.