Provides that a utilization review entity may only impose prior authorization requirements on less than 1% of any given specialty or health care service and 1% of health care providers overall in a calendar year. Prohibits a utilization review entity from requiring prior authorization for: (1) a health care service that is part of the usual and customary standard of care; (2) a prescription drug that is approved by the federal Food and Drug Administration; (3) medication for opioid use disorder; (4) pre-hospital transportation; or (5) the provision of an emergency health care service. Sets forth requirements for a utilization review entity that requires prior authorization of a health care service. Provides that all adverse determinations and appeals must be reviewed by a physician who meets certain conditions. Requires a utilization review entity to provide an exemption from prior authorization requirements if in the most recent 12 month period the utilization review entity has approved or would have approved at least 80% of the prior authorization requests submitted by the health care provider for a particular health care service. Repeals superseded provisions regarding prior authorization. Makes corresponding changes.
Sen. Chris Garten
Sponsored bills
A CONCURRENT RESOLUTION recognizing the ongoing military efforts of the USS Indianapolis (LCS 17) and its crew.
A CONCURRENT RESOLUTION recognizing the ongoing military efforts of the USS Indianapolis (LCS 17) and its crew.
A SENATE RESOLUTION memorializing Senator Jack Sandlin.
A CONCURRENT RESOLUTION recognizing South Bend Police Officer Brian Meador.
A CONCURRENT RESOLUTION recognizing South Bend Police Officer Brian Meador.
A SENATE RESOLUTION to honor Senator Eddie Melton upon his retirement from the Indiana Senate.
Adds a definition of "mixed beverage". Allows the holder of a wine wholesaler's permit to take certain actions concerning mixed beverages and flavored malt beverages. Provides that a wine wholesaler may possess, transport, sell, and deliver mixed beverages to a person who holds a particular permit. Repeals a provision concerning a wine wholesaler that also holds a liquor permit.
Provides that the office of administrative legal proceedings (OALP) is the ultimate authority for agencies subject to the jurisdiction of the OALP. Provides that a court conducting a judicial review hearing shall review questions of law and fact de novo. Makes conforming amendments.
Allows a city on the Ohio River that established a port authority to annex territory that is not contiguous to the city boundaries if a railroad owned by the port authority connects the city to the annexed territory. Prohibits a public official from being appointed to the executive board of a military base reuse authority after June 30, 2024, and sets certain minimum qualifications for members.