This bill amends the Utilization Review Act in Nebraska by introducing a requirement for health carriers and utilization review agents to implement and maintain a prior authorization application programming interface by January 1, 2028. This new provision aligns with federal regulations outlined in 45 C.F.R. 156.223(b) as they existed on January 1, 2025. Additionally, the bill clarifies that this requirement does not apply to prior authorization requests for drug coverage, with "drug" defined according to 45 C.F.R. 156.221(b)(1)(v) as of the same date.

Furthermore, the bill updates the citation for the Utilization Review Act to include the new section, ensuring that the act is cohesive and up-to-date. The original section 44-5416 of the Reissue Revised Statutes of Nebraska is repealed, streamlining the legal framework surrounding utilization review in the state.

Statutes affected:
Introduced: 44-5416