New Law Will Affect Health Insurance Coverage

Jennifer Lewerenz | Dec 28, 2020 AT 12:00 pm

(KNSI) – A new law going into effect on January 1st will affect how health insurance pays for certain items.

The way it stands now, if you switch your health insurance plan in between when you are approved for planned surgery and when the surgery takes place, your new insurance company doesn’t have to honor that pre-authorization.

Under the new law, the new provider “will be required to comply with previous prior authorizations for health care services for the first 60 days after enrollment while a new utilization review is conducted. The enrollee, or a medical professional acting on their behalf, will be required to submit documentation to access this.”

The law also says that health insurance providers must post certain data on their public websites that include the number of prior authorization requests for which an authorization was issued and the reasons for prior authorization denial. Insurance companies must provide the information online and in layman’s terms, so it is easy for people to read and understand.

Companies have until April 1st, 2022 to do it, and the terms must be updated each April 1st after that.