All Roll Calls
Yes: 166 • No: 1
UtahS.B. 3192026 General SessionSenateWALLET
Health Insurance Preauthorization Amendments
Sponsored By: John D. Johnson (Republican)
Signed by Governor
Health InsuranceInsuranceInsurance DepartmentBusinessHealth and Human ServicesHealth Benefits and ClaimsCommercial Health Insurance\Managed Care Contracts
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Bill Overview
Analyzed Economic Effects
7 provisions identified: 4 benefits, 0 costs, 3 mixed.
Faster decisions and fair appeals
Starting January 1, 2027, standard preauthorization decisions must be made within 7 calendar days after all needed information is received. Urgent requests must be decided within 72 hours; if information is missing, the insurer must say what is needed within 1 business day, give at least 2 business days to respond, and decide within 2 business days after getting it. Insurers must treat requests as pre‑service claims under federal and state rules and allow corrected resubmissions for unintentional errors. Appeals about medical necessity must be reviewed by a licensed physician (or a licensed physician or pharmacist for drug cases), with independent judgment and relevant expertise. Every denial must explain why, list approved and denied billing codes on page one, and explain how to start an appeal, including expedited appeals.
Insurers can't revoke valid approvals
Beginning January 1, 2027, an insurer cannot take back a granted preauthorization when the provider requested it, the service matched the approval, you were eligible that day, the claim matches, and there was no fraud. The law also requires the insurer to pay a contracted provider for an authorized service under the plan terms. The insurer may deny payment only in limited cases, such as late claim filing, a different code than approved, the service was not covered that day, the provider was not contracted that day, the insurer has no liability, or you were not eligible.
Longer approvals and stable drug coverage
Beginning January 1, 2027, authorizations must state how long they are valid and how long the service lasts. For chronic or long‑term conditions, approvals must last at least 12 months (except experimental drugs). Outpatient service approvals must last at least 6 months. If a drug is removed from the formulary, you, your designee, or your provider can request a continuity‑of‑care exemption; mid‑year removals for people on active treatment need at least 30 days’ notice. Insurers must give 30 days’ notice before changing preauthorization rules and update their website; exceptions apply for urgent safety issues and newly covered drugs or devices.
No preapproval for emergencies
Beginning January 1, 2027, insurers cannot require preauthorization for emergency health care. This prevents delays in urgent treatment.
Ambulance pay statute ends 2027
On July 1, 2027, the ground ambulance reimbursement statute is repealed. How provider payments or patient bills change depends on other laws and contracts in place at that time.
Interstate insurance rule ends 2033
On July 1, 2033, the statute on coordination with other states is repealed. Practical effects depend on how agencies used that statute.
Public reporting and AI transparency
Starting January 1, 2027, insurers must post plain‑language preauthorization rules and performance data on public websites and state if they use AI to review requests. If AI is used, insurers must also notify the Utah Insurance Department, all network providers, and each enrollee. Each April 1, insurers report the share of non‑urgent authorizations where provider notice took more than one week for the prior year. Annual aggregated preauthorization reports are due by March 1 each year (the statute references March 1, 2026); the law takes effect January 1, 2027. The Department compiles and publishes the data and can make rules. The detailed reporting and the related rulemaking authority end July 1, 2029.
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Sponsors & Cosponsors
Sponsor
John D. Johnson
Republican • Senate
Cosponsors
Katy Hall
Republican • House
Roll Call Votes
Senate vote • 3/5/2026
Senate/ concurs with House amendment
Yes: 26 • No: 0
House vote • 3/4/2026
House/ passed 3rd reading
Yes: 69 • No: 1
House vote • 3/4/2026
House/ uncircled
Yes: 0 • No: 0
House vote • 3/4/2026
House Comm - Substitute Recommendation
Yes: 8 • No: 0
House vote • 3/4/2026
House Comm - Favorable Recommendation
Yes: 9 • No: 0
House vote • 3/4/2026
House/ circled
Yes: 0 • No: 0
Senate vote • 3/3/2026
Senate/ passed 3rd reading
Yes: 28 • No: 0
Senate vote • 3/2/2026
Senate/ passed 2nd reading
Yes: 22 • No: 0
Senate vote • 3/2/2026
Senate/ uncircled
Yes: 0 • No: 0
Senate vote • 3/2/2026
Senate/ circled
Yes: 0 • No: 0
House vote • 2/27/2026
Senate Comm - Favorable Recommendation
Yes: 4 • No: 0
Actions Timeline
Governor Signed
3/19/2026Senate/ to Governor
3/13/2026SenateSenate/ received enrolled bill from Printing
3/13/2026SenateSenate/ enrolled bill to Printing
3/11/2026SenateEnrolled Bill Returned to House or Senate
3/11/2026Draft of Enrolled Bill Prepared
3/6/2026Bill Received from Senate for Enrolling
3/6/2026Senate/ signed by President/ sent for enrolling
3/6/2026SenateSenate/ received from House
3/6/2026SenateHouse/ to Senate
3/5/2026HouseHouse/ signed by Speaker/ returned to Senate
3/5/2026HouseHouse/ received from Senate
3/5/2026HouseSenate/ to House
3/5/2026SenateSenate/ concurs with House amendment
3/5/2026SenateSenate/ placed on Concurrence Calendar
3/5/2026SenateSenate/ received from House
3/5/2026SenateHouse/ to Senate
3/4/2026HouseHouse/ passed 3rd reading
3/4/2026HouseHouse/ uncircled
3/4/2026HouseHouse/ circled
3/4/2026HouseHouse/ 3rd reading
3/4/2026HouseHouse/ 2nd reading
3/4/2026HouseHouse/ Rules to 3rd Reading Calendar
3/4/2026HouseHouse/ return to Rules due to fiscal impact
3/4/2026HouseHouse/ comm rpt/ substituted
3/4/2026House
Bill Text
Enrolled
3/11/2026
Substitute #1
3/4/2026
Introduced
2/23/2026
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