FILE - Mississippi Senate Insurance Committee Chairman Walter Michel, R-Ridgeland, speaks Feb. 1, 2023, in the state Capitol in Jackson. Michel on Wednesday, Jan. 31, 2024, explained a bill that would set rules for how insurance companies decide whether to cover medical procedures or prescription drugs. (AP Photo/Rogelio V. Solis, File)
- The bill requires insurance companies to approve urgent and non-urgent medical care within a designated time frame while also requiring the process be conducted through an online web portal.
On Tuesday, lawmakers in the Mississippi Senate moved to concur, or agree, with changes made by the House of Representatives to this year’s prior authorization legislation, sending it on Governor Tate Reeves for his signature.
Prior authorization addresses medical procedures or medication that may require insurance approval before services can be rendered or prescriptions can be filled.
State Senator Walter Michel (R) took up the issue for the second year in a row through SB 2140. The bill ultimately requires insurance companies to approve urgent and non-urgent medical care within a designated time frame. The bill also outlines a requirement for the process to be conducted through an online web portal in which physicians can request the prior authorization and appeal any denied applications.
The new legislation appoints the Mississippi Department of Insurance as the overseeing agency of the proposed web portal and includes Medicaid and the state’s health plan within the prior authorization process.
The House amended the timeframe in which insurers must respond to requests from 24-hours for emergent requests to 48-hours. Representatives also amended the bill from five working days to seven for non-emergent requests.
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“The bill that we have would be a great improvement for the process. It’s great for the medical community, it’s great for the patient and it’s an improvement for the insurance company as well,” said Senator Michel.
Michel said the primary motivation for changes to the prior authorization process was to benefit the patient. He shared a story about an individual who was at a standstill for several months on a prescription drug that ultimately only cost them $36 per month.
The changes will incur minimal or no costs for the state health plan, Michel said. He did anticipate the push for an appropriation to the Department of Insurance (MDI), a request made by Commissioner Mike Chaney (R), since the department will now be required to oversee the portal. This will likely result in two new hires.
“No one has been able to quantify any costs,” said Michel. “Basically, what it is doing is setting up a portal and putting timelines on which the insurance companies must respond. Now, how is that going to cost money?”
Michel said legislative committee attorneys as well as representatives from MDI could not find any unexpected costs because of the legislation. However, the bill will not go into effect until July 1, 2024, giving lawmakers six months to monitor it and make changes in next session if necessary.
Last year’s prior authorization bill was vetoed by Governor Reeves who cited concerns over the web portal and regulations as his motivation for the veto. He also expressed a desire to see the state health plan added and the overseeing agency to be the MDI, two changes that were made with the 2024 bill.
Senator Michel said he did not have any insight as to whether the Governor would veto SB 2140 this year or not.
Governor Reeves has five days to sign or veto the bill. If he chooses to veto it, the Legislature can bring the bill back before the body with a two-thirds vote and override the veto.
Sarah Ulmer
