The bill amends existing laws concerning prior authorization requests for medical care covered by health care insurers in Alaska, establishing a new process that requires insurers to create a more efficient system to reduce administrative burdens on providers. Insurers must respond to standard requests within 72 hours and expedited requests within 24 hours, with any inadequately addressed requests automatically deemed approved after the specified time. Additionally, the bill mandates the maintenance of a prior authorization application programming interface to enhance process efficiency and ensure compliance with federal interoperability standards.

Moreover, the legislation sets forth specific standards for prior authorization, including the obligation for insurers to publish their criteria based on peer-reviewed clinical evidence. It addresses step therapy protocols for patients with Stage 4 advanced metastatic cancer, ensuring they are not subjected to unnecessary restrictions. The bill also introduces definitions related to health care insurers and utilization review organizations, and it allows the director of the division of insurance to adopt necessary regulations for implementation. While Section 4 of the Act takes immediate effect, the remainder will be effective on January 1, 2027.

Statutes affected:
HB0144A, AM HB 144, introduced 03/21/2025: 21.07.080, 21.07.005, 21.07.090, 21.07.100, 21.07.180, 21.07.110, 21.07.120, 21.07.130, 21.07.140, 21.07.150, 21.07.160, 21.07.170, 21.06.120, 21.06.230, 21.07.250