Providers use standard forms or automated systems for care approvals

Providers use approved forms for prior authorization requests, and review agents accept and process those forms. These provisions cover health care providers and utilization review agents handling prior authorization requests. An agent may ask the department for an exemption if it maintains an automated electronic process that standardizes prior authorization. The agent must give providers at least 90 days’ notice before starting that process. Providers must use it within 90 days after notice, but the agent may grant more time for good cause. The forms are limited to two printed pages, excluding information requested by the review agent and supporting notes or documents. Providers must switch to an exempt electronic process within 90 days after notice.

Covered health care facilities share clinical information with the designated health information exchange. The sharing duty covers the health care facilities listed in the text, subject to the stated exclusions. The duty applies to listed facilities, including hospitals, clinics, pharmacies, and diagnostic, laboratory, or imaging centers. It excludes state-owned or state-operated facilities and assisted-living, nursing, and skilled nursing facilities. A facility may seek a waiver from the board because of a technology burden. The board reviews waivers each year and cannot require facilities to buy or contract for an electronic records system. Shared patient information must follow federal privacy and security rules. Individuals may opt out of sharing, except for required public health reporting. The text gives January 1, 2027, as the facility participation date, but the amendment formatting is unclear.

The Health Information Technology Board includes a representative of an insurer that offers a health insurance plan. The insurer must offer at least one health insurance plan as defined in the text.