HB 1199 requires health insurance companies and utilization review organizations to track and annually report data on their prior authorization decisions to South Dakota's Division of Insurance, including how many requests they approved or denied and how quickly they made decisions. The Division of Insurance must then publish these reports publicly online within 60 days so patients and the public can see how insurance companies handle prior authorization requests for medical care.
This amendment completely rewrote HB1199 from defining terms related to preauthorization and utilization review into a bill requiring utilization review organizations and health carriers to submit annual reports to the Division of Insurance detailing approval/denial rates and processing times for prior authorization requests. The change significantly NARROWS and REDIRECTS the bill's focus from establishing a comprehensive regulatory framework to creating a transparency and reporting requirement for authorization decisions.
This change converts the bill from an engrossed version (extensively amended with unclear scope) into its final enrolled form, confirming the bill's core purpose: requiring utilization review organizations and health carriers to conduct annual reviews of prior authorization requirements, eliminate those that are routinely approved without clear justification, and report their findings to the Division of Insurance—while explicitly excluding dental, pharmaceutical, and prescription drug services from these requirements. The shift from engrossed to enrolled status indicates the bill's final language has been clarified and approved for passage.
Other amendments
Signed by the Governor H.J. 579
Delivered to the Governor H.J. 534
Signed by the President S.J. 486
Signed by the Speaker H.J. 516
Senate Do Pass Passed, YEAS 34, NAYS 0. S.J. 444
Health and Human Services Certified uncontested, placed on consent S.J. 23
Health and Human Services Do Pass Passed, YEAS 7, NAYS 0. S.J. 23
Health and Human Services Scheduled for hearing
First read in Senate and referred to Senate Health and Human Services S.J. 340
House of Representatives Do Pass Passed, YEAS 65, NAYS 1. H.J. 367
Health and Human Services Certified uncontested, placed on consent
Health and Human Services Do Pass Amended Passed, YEAS 13, NAYS 0.
Health and Human Services Hoghoused
Health and Human Services Scheduled for hearing
First read in House and referred to House Health and Human Services H.J. 177
Prime sponsor · Sen.
R
Prime sponsor · Rep.
R
Cosponsors
Do Pass
Health and Human Services — Do Pass
Do Pass
Health and Human Services — Do Pass Amended