H.B. No. 2150 amends various sections of the Insurance Code to enhance telephone access for health benefit plan verifications, preauthorization requests, and utilization review requests. The bill mandates that health maintenance organizations and insurers must provide personnel at a toll-free number available 24 hours a day, seven days a week, including legal holidays, to respond to these requests. This replaces the previous requirement for availability only during specific hours on weekdays and limited hours on weekends and holidays. Additionally, the bill requires these organizations to have a telephone system capable of accepting or recording calls when personnel are unavailable and to respond to calls as soon as possible, but no later than two hours after the call is received.

The bill also includes provisions for utilization review agents, ensuring they have personnel available 24/7 to discuss patient care and respond to review requests. Similar to the requirements for health maintenance organizations and insurers, utilization review agents must have a system in place for accepting calls during periods when personnel are not available and must respond to those calls promptly. The changes aim to improve accessibility and responsiveness in the healthcare system, ensuring that individuals can obtain necessary verifications and authorizations without delay. The act is set to take effect on September 1, 2025.

Statutes affected:
Introduced: Insurance Code 843.347, Insurance Code 843.348, Insurance Code 1301.133, Insurance Code 1301.135, Insurance Code 4201.004 (Insurance Code 843, Insurance Code 4201, Insurance Code 1301)