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Second Substitute H.B. 323

Representative Bradley G. Last proposes the following substitute bill:


             1     
HEALTH INSURANCE PRIOR AUTHORIZATION

             2     
2013 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Bradley G. Last

             5     
Senate Sponsor: Evan J. Vickers

             6     
             7      LONG TITLE
             8      General Description:
             9          This bill amends the Insurance Code related to health insurance and prior authorization
             10      forms for prescription drugs.
             11      Highlighted Provisions:
             12          This bill:
             13          .    requires the Insurance Commissioner to work in consultation with national and state
             14      organizations involved with the standardized exchange of health data, and the
             15      electronic exchange of health data, to:
             16              .    review the prior authorization process;
             17              .    evaluate the efficiencies of standardized electronic forms; and
             18              .    report to the Legislature's Business Labor Interim Committee.
             19      Money Appropriated in this Bill:
             20          None
             21      Other Special Clauses:
             22          None
             23      Utah Code Sections Affected:
             24      ENACTS:
             25          31A-22-614.7, Utah Code Annotated 1953


             26     
             27      Be it enacted by the Legislature of the state of Utah:
             28          Section 1. Section 31A-22-614.7 is enacted to read:
             29          31A-22-614.7. Uniform claims processing -- Electronic exchange of prescription
             30      drug pre-authorization.
             31          (1) The commissioner shall consult with national and state organizations involved with
             32      the standardized exchange of health data, and the electronic exchange of health data, to study
             33      and review:
             34          (a) the process of prior authorization of prescription drugs; and
             35          (b) the standards for the use and electronic exchange of a uniform prescription drug
             36      prior authorization form that meet federal mandatory minimum standards and follow the
             37      adoption of national requirements for transaction and data elements in the federal Health
             38      Insurance Portability and Accountability Act.
             39          (2) The commissioner and the organization described in Subsection (1) shall report
             40      their progress and findings to the Legislature's Business and Labor Interim Committee before
             41      October 1, 2013 and before November 1, 2014.


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