HB0076

Failed

Prior authorization-amendments.

Require Wyoming-licensed health care providers to make prior authorization decisions and review appeals for insurance coverage determinations.

Full legal title

AN ACT relating to the insurance code; requiring prior authorization adverse determinations to be determined by Wyoming-licensed health care providers; requiring prior authorization appeals to be reviewed by Wyoming-licensed health care providers; specifying applicability; and providing for an effective date.

Business Health

Sponsor:

Co-sponsors: Representative(s) Clouston, Geringer, Styvar, Wylie, Senator(s) Brennan

View on wyoleg.gov Introduced Text (PDF)Digest (PDF)Fiscal Note (PDF)

What does this bill do?

Requires that prior authorization adverse determinations and appeals be reviewed by Wyoming-licensed health care providers rather than providers licensed in other states.

Amends the qualification requirements for persons making adverse determinations to require they hold a current and unrestricted license to practice in Wyoming, removing the previous allowance for licenses from any state, territory, commonwealth, or the District of Columbia. (W.S. 26-55-104(a)(iii), Sec. 1)
Amends the qualification requirements for persons reviewing appeals of adverse determinations to require a current and unrestricted license to practice in Wyoming, removing the previous allowance for licenses from other states, territories, commonwealths, or the District of Columbia. (W.S. 26-55-106(a)(iii), Sec. 1)
Specifies that the licensing requirements apply to prior authorization adverse determinations made or appealed on or after July 1, 2025. (Sec. 2)

Effective: July 1, 2025

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Actions (5)

3/3/2025(House)

H:Died in Committee Returned Bill Pursuant to HR 5-4

2/7/2025(House)

H No report prior to CoW Cutoff

1/15/2025(House)

H Introduced and Referred to H10 - Labor

1/2/2025(House)

H Received for Introduction

12/24/2024(LSO)

Bill Number Assigned