Missouri legislation · 2026 Regular Session
Missouri HB1675: Creates provisions relating to prior authorization of health care services
Status: In committee, May 15, 2026
What the bill says
To amend chapter 376, RSMo, by adding thereto five new sections relating to prior authorization of health care services. Section A. Chapter 376, RSMo, is amended by adding thereto five new sections, to be known as sections 376.2100, 376.2102, 376.2104, 376.2106, and 376.2108, to read as follows: 376.2100. 1. Except as otherwise provided in subsection 1 of section 376.2108, as used in sections 376.2100 to 376.2108, terms shall have the same meanings as are ascribed to them under section 376.1350. 2. As used in sections 376.2100 to 376.2108, the term "evaluation period" shall mean the first six.
From the introduced text:
To amend chapter 376, RSMo, by adding thereto five new sections relating to prior authorization of health care services. Section A. Chapter 376, RSMo, is amended by adding thereto five new sections, to be known as sections 376.2100, 376.2102, 376.2104, 376.2106, and 376.2108, to read as follows: 376.2100. 1. Except as otherwise provided in subsection 1 of section 376.2108, as used in sections 376.2100 to 376.2108, terms shall have the same meanings as are ascribed to them under section 376.1350. 2. As used in sections 376.2100 to 376.2108, the term "evaluation period" shall mean the first six months of the calendar year or the last six months of the calendar year. 376.2102. 1. A health carrier or utilization review entity shall not require a health care provider to obtain prior authorization for a health care service unless the health carrier or utilization review entity makes a determination that in the most recent evaluation period the health carrier or utilization review entity has approved or would have approved less than ninety percent of the prior authorization requests submitted by that provider for that health care service. 2. A health carrier or utilization review entity shall not require a health care provider to obtain prior authorization for any health care services unless the health carrier or utilization review entity makes a determination …