Bill Commons

MO SB 897

in committee

SB 897 - This act provides that health care providers shall not be required to obtain prior authorization for a health care service unless the health carrier or utilization review entity determines that in the most recent evaluation period, as defined in the act, less than 90% of the prior authorization requests submitted by that provider for that health care service were approved or would have been approved. Additionally, health care providers shall not be required to obtain prior authorization for any health care services unless the health carrier or utilization review entity has approved or would have approved less than 90% of all prior authorization requests submitted by that provider for health care services. Health carriers and utilization review entities shall notify providers within 25 days after a determination is made under the act, shall include in the notification certain information used in making the determination, shall establish an appeals process for the providers, and shall maintain an online prior authorization portal as described in the act. No health carrier or utilization review entity shall deny or reduce payment to a health care provider for a health care service for which the provider has prior authorization, except as described in the act. This act shall not apply to MO HealthNet services not provided through a managed care organization, or to providers who have not participated in a health benefit plan offered by the health carrier for at least one full evaluation period. This act is identical to HB 1675 (2026), substantially similar to HB 618 (2025) and to provisions in HCS/SB 94 (2025), and is similar to SB 846 (2026), SB 841 (2026), HCS/HB 3010 (2026), SB 230 (2025), SB 983 (2024), HB 1976 (2024), SB 576 (2023), and HB 1045 (2023). TAYLOR MIDDLETON

Missouri · 2026 Regular Session · upper

Description

SB 897 - This act provides that health care providers shall not be required to obtain prior authorization for a health care service unless the health carrier or utilization review entity determines that in the most recent evaluation period, as defined in the act, less than 90% of the prior authorization requests submitted by that provider for that health care service were approved or would have been approved. Additionally, health care providers shall not be required to obtain prior authorization for any health care services unless the health carrier or utilization review entity has approved or would have approved less than 90% of all prior authorization requests submitted by that provider for health care services. Health carriers and utilization review entities shall notify providers within 25 days after a determination is made under the act, shall include in the notification certain information used in making the determination, shall establish an appeals process for the providers, and shall maintain an online prior authorization portal as described in the act. No health carrier or utilization review entity shall deny or reduce payment to a health care provider for a health care service for which the provider has prior authorization, except as described in the act. This act shall not apply to MO HealthNet services not provided through a managed care organization, or to providers who have not participated in a health benefit plan offered by the health carrier for at least one full evaluation period. This act is identical to HB 1675 (2026), substantially similar to HB 618 (2025) and to provisions in HCS/SB 94 (2025), and is similar to SB 846 (2026), SB 841 (2026), HCS/HB 3010 (2026), SB 230 (2025), SB 983 (2024), HB 1976 (2024), SB 576 (2023), and HB 1045 (2023). TAYLOR MIDDLETON

Introduced
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Status date
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Latest action
2026-03-03 — Hearing Conducted S Insurance and Banking Committee
Bill type
bill
Last updated
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Sponsors

  • Brown (26), Benprimary

Committees

Not provided by source.

Action timeline

  1. 2026-03-03

    Hearing Conducted S Insurance and Banking Committee

  2. 2026-01-08

    Second Read and Referred S Insurance and Banking Committee

    reading-2,referral-committee

  3. 2026-01-07

    S First Read

    reading-1

  4. 2025-12-01

    Prefiled

Versions

Documents

Votes

Not provided by source.

Related bills

No related bills recorded for this bill.

Official source

https://www.senate.mo.gov/BillTracking/Bills/BillInformation?year=2026&billid=252

Attribution

Data from openstates_bulk_csv, retrieved 2026-07-24T05:25:15.077812Z

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