Since January, 10 states have passed laws reforming prior authorization rules in an effort to reduce care delays and save time for physicians and patients, according to an Aug. 19 report from the American Medical Association.
Vermont, Minnesota, Wyoming, Colorado, Illinois, Mississippi, Maine, Maryland, Oklahoma and Virginia have all passed prior authorization legislation this year, with additional states, including Massachusetts, considering more reform bills before the end of 2024.
Minnesota also enacted strong prior authorization legislation in 2020, shortening response times and increasing transparency for patients. In 2024, the state enacted additional legislation that prevents the use of prior authorization for the non medication parts of cancer care and mental health care.
In Vermont, legislators passed a bill that says patients with chronic conditions do not have to get new prior authorizations for treatment that is unchanged and that insurers must respond to urgent prior authorization requests within 24 hours. The legislation also requires new insurers accept a previous health plan’s prior authorization for up to 90 days.
In Wyoming, lawmakers enacted legislation that creates a "gold card" program for accepting physicians from prior authorization when they have a track record of consistently being approved for certain procedures or medications and requires that prior authorizations for patients with chronic conditions remain valid for longer periods of time.