2025 25LSO-0555
STATE OF WYOMING
HOUSE BILL NO. HB0076
Prior authorization-amendments.
Sponsored by: Representative(s) Brown, L, Clouston,
Geringer, Styvar and Wylie and Senator(s)
Brennan
A BILL
for
1 AN ACT relating to the insurance code; requiring prior
2 authorization adverse determinations to be determined by
3 Wyoming-licensed health care providers; requiring prior
4 authorization appeals to be reviewed by Wyoming-licensed
5 health care providers; specifying applicability; and
6 providing for an effective date.
7
8 Be It Enacted by the Legislature of the State of Wyoming:
9
10 Section 1. W.S. 26-55-104(a)(iii) and
11 26-55-106(a)(iii) are amended to read:
12
13 26-55-104. Persons qualified to make adverse
14 determinations.
15
1 HB0076
 2025 STATE OF WYOMING 25LSO-0555
1 (a) Each health insurer or contracted utilization
2 review entity shall ensure that all adverse determinations
3 are made by a physician or other appropriate licensed
4 health care provider who has:
5
6 (iii) Unless otherwise required under Wyoming
7 law, a current and unrestricted license to practice within
8 the scope of their profession in a state, territory,
9 commonwealth of the United States or the District of
10 Columbia Wyoming;
11
12 26-55-106. Requirements applicable to persons
13 reviewing appeals.
14
15 (a) Each health insurer or contracted utilization
16 review entity shall ensure that all appeals of adverse
17 determinations are reviewed by a physician or other
18 appropriate licensed health care provider who has:
19
20 (iii) A current and unrestricted license to
21 practice within the scope of their medical profession in a
22 state, territory, commonwealth of the United States or the
23 District of Columbia Wyoming;
2 HB0076
 2025 STATE OF WYOMING 25LSO-0555
1
2 Section 2. This act applies to prior authorization
3 adverse determinations made or appealed on or after July 1,
4 2025.
5
6 Section 3. This act is effective July 1, 2025.
7
8 (END)
3 HB0076


Statutes affected:
Introduced: 26-55-104, 26-55-106