RELATING TO HEALTH.

Removed page headers, footers, and metadata from the original document version

Consolidated and cleaned up the legislative text formatting and line breaks

Adjusted some text spacing and removed redundant line breaks throughout the document

Added automatic approval timelines: 48 hours for non-urgent services and 24 hours for urgent services if the utilization review entity fails to respond or request additional information.

Created a new Health Care Appropriateness and Necessity Working Group to research standards, assess necessity of prior authorization requirements, and make recommendations to improve the process.

Modified reporting requirements to include compilation of data by provider of health insurance, health care setting, and line of business with specific posting deadlines.

Added requirement for utilization review entities to notify patients when prior authorization is being questioned for medical necessity within the response timeframe.

Added new statutory definitions for 'Enrollee', 'Health care professional', 'Health care service', 'Prior authorization', 'Urgent health care service', and 'Utilization review entity'.

Set effective date of July 1, 3000, which appears to be a placeholder or error in the original text.

Prior authorization approval timelines were shortened from 48 hours to 24 hours for urgent services, with automatic approval if not decided within the timeframe.

Effective date changed from July 1, 3000 to a placeholder date, indicating the bill is still in draft status.

New requirement for utilization review entities to submit annual reports containing prior authorization data to the State Health Planning and Development Agency.

Establishment of a Health Care Appropriateness and Necessity Working Group to determine standards for prior authorization and make recommendations to improve the process.

New statutory definitions for 'enrollee', 'health care professional', 'health care service', 'prior authorization', 'urgent health care service', and 'utilization review entity'.

Changed the reporting deadline for utilization review entities from January 1 to January 31 of each year.

Renamed the oversight body from 'health care appropriateness and necessity commission' to 'health care appropriateness and necessity working group' with advisory-only recommendations.

Added new statutory definitions for 'prior authorization data' and 'utilization review entity' to clarify compliance requirements.

Extended the working group's reporting deadline to twenty days prior to the convening of the 2026 regular session.

Reformatted the document structure and numbering, converting it to a CD1 computer-generated version.