Revises provisions relating to health insurance. (BDR 57-731)

SB 398 revises health insurance prior authorization rules for medical and dental care, affecting insurers covering Medicaid, Children’s Health Insurance Program (CHIP), and public employee plans. It requires insurers to publicly list services needing prior authorization and their clinical review criteria, respond within 24-48 hours (depending on urgency), and have licensed physicians/dentists make adverse decisions. The bill prohibits denying claims if prior authorization wasn’t required for the care at the time, bans prior authorization for emergency services or certain pain medications for terminal conditions, and mandates equal treatment for mental health appeals. Insurers must also automatically exempt high-performing providers from prior authorization requirements and streamline appeals processes.