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 fundamentally rewrote the bill from defining utilization review terms and adverse determinations into requiring utilization review organizations and health carriers to submit annual reports to the Division of Insurance detailing approval and denial rates for urgent and nonurgent prior authorization requests, along with average and median processing times. The change REDIRECTS the bill's focus from establishing definitional frameworks for preauthorization processes to creating transparency and accountability mechanisms through mandatory regulatory reporting.
This amendment changes the bill from a "hoghoused" version that was extensively amended back to its original form—a straightforward measure requiring utilization review organizations and health carriers to report on prior authorization approvals/denials and to eliminate prior authorization requirements for services that are routinely approved at rates suggesting the requirement doesn't justify its administrative costs. The change RESTORES the bill's original purpose of increasing transparency and streamlining unnecessary prior authorization processes.
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