On October 29, the Senate Committee on Insurance, Housing, Rural Issues and Forestry held a hearing on two bills limiting prior insurance authorization. WiAHC submitted written testimony on both bills.

Senate Bill 434 – Transparency and Regulation of Prior Authorization Requirements

This legislation makes the following changes to existing prior insurance authorization requirements:

• Limits prior authorization decision timelines to 72 hours for standard requests and 24 hours for urgent care requests.
• Requires a patient’s new insurer to honor a prior authorization decision made by a utilization review entity associated with the patient’s prior insurer for at least 90 days. 

WiAHC submitted written testimony in support of this legislation, bearing in mind that commercial insurers in Wisconsin often take as long as 10-15 days to respond to prior authorization requests from home health care agencies.

Senate Bill 373 – Addresses Prior Authorization for Coverage of Physical Therapy, Occupational Therapy, Speech Therapy, and Chiropractic Services

This legislation does the following:

• Allows 12 patient visits for physical therapy, occupational therapy, speech therapy, and chiropractic services – without requiring prior authorization.
• Limits the timeframe for subsequent insurance reauthorization to three business days.

WiAHC submitted written testimony noting that our organization appreciates this legislation, as home health agencies employ physical therapists, occupational therapists, and speech therapists. However, our organization’s testimony also requests the addition of home-based skilled nursing care to this legislation.