# Indiana SB 480: Prior authorization. Indiana SB 480, Prior authorization., is a First Regular Session 124th General Assembly (2025) Senate bill sponsored by Tyler Johnson (Republican); status signed, last action 2025-05-01 (Signed by the Governor); PRIA reads it as touching household money (as of 2026-10-17). - Canonical: https://policyrisk.com/state-bill/IN-SB480-2025 - As of: 2026-10-17 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: Indiana SB 480 - State: Indiana - Session: First Regular Session 124th General Assembly (2025) - Title: Prior authorization. - Status: signed - Chamber: Senate - Introduced: 2025-01-13 - Last action: 2025-05-01, Signed by the Governor - Sponsor: Tyler Johnson (Republican) - Cosponsors: 46 - Subjects: health and provider services, appropriations, the house, insurance - Touches household money: yes - Roll calls: 3 (180 yes, 4 no in all) - Economic provisions PRIA read: 8 ## Summary Sets forth requirements for a utilization review entity that requires prior authorization of a health care service. Prohibits a utilization review entity from requiring prior authorization for the first 12 physical therapy or chiropractic visits of each new episode of care. Provides that a claim for reimbursement for a covered service or item provided to an insured or enrollee may not be denied on the sole basis that the referring provider is an out of network provider. Repeals superseded provisions regarding prior authorization. Makes corresponding changes. ## Bill overview: provisions PRIA read - Faster care decisions and patient appeals: benefit, medium. Beginning July 1, 2025, reviewers must answer urgent care approval requests within 24 hours and other care or drug requests within 48 hours. Weekends and state and federal holidays do not count. Decisions denying, reducing, or ending coverage for medical need, effectiveness, care setting, or experi… - Stronger emergency coverage for insured patients: benefit, medium. Beginning July 1, 2025, reviewers must cover emergency services needed to screen and stabilize covered patients. Patients or providers get at least 24 hours after emergency admission or service to give notice. A provider’s written certification within 72 hours after admission creates a presumption… - Broader patient rights with insurance enforcement: benefit, low. Beginning July 1, 2025, the law covers more approval reviewers, including those working for employers, health plans, and preferred provider organizations. It also reaches reviewers for other organizations providing or managing covered health benefits and requires self-insured public employer progra… - Clearer approval rules and request tracking: benefit, low. Beginning July 1, 2025, providers must send non-drug approval requests securely online or through a software connection; reviewers must accept them and issue tracking codes. Written agreements allow non-electronic requests using the state’s standard form for financial hardship, poor internet access… - Fewer coverage reversals for patient care: benefit, low. Beginning July 1, 2025, reviewers cannot revoke, limit, or add conditions to approvals when care starts within 45 days of provider receipt. Weekends and state and federal holidays do not count toward those 45 days. For approvals requested after June 30, 2025, claims matching the approval can be den… - Patients get twelve approval-free therapy visits: benefit, low. Beginning July 1, 2025, reviewers cannot require prior approval for the first 12 physical therapy visits in each new episode. The same protection covers the first 12 chiropractic visits in each new episode of care. This approval exemption does not apply to Medicaid or state employee health plans. - Qualified clinical reviewers protect patient care: benefit, low. Beginning July 1, 2025, clinical peers must decide medical-need denials and appeals under an Indiana-licensed physician’s clinical direction. Physician reviewers generally must match the requesting physician’s specialty and, when applicable, subspecialty. Primary care reviewers need matching genera… - Some Medicaid services lack approval protections: cost, low. Beginning July 1, 2025, the prior approval chapter excludes services under Indiana’s Pathways for Aging and Health and Wellness Medicaid waivers. It also excludes the named step-therapy exception procedures under IC 5-10-8-17, IC 27-8-5-30, and IC 27-13-7-23. The chapter does not apply where federa… ## Sponsors and cosponsors - Sponsor: Tyler Johnson (Republican), Senate - Cosponsor: Andrea Hunley (Democratic), Senate - Cosponsor: Andy Zay - Cosponsor: Blake Doriot (Republican), Senate - Cosponsor: Brad Barrett (Republican), House - Cosponsor: Brett Clark (Republican), Senate - Cosponsor: Brian Buchanan (Republican), Senate - Cosponsor: Cyndi Carrasco (Republican), Senate - Cosponsor: Dan Dernulc (Republican), Senate - Cosponsor: Daryl Schmitt (Republican), Senate - Cosponsor: David Niezgodski (Democratic), Senate - Cosponsor: Ed Charbonneau (Republican), Senate - Cosponsor: Eric Bassler (Republican), Senate - Cosponsor: Eric Koch (Republican), Senate - Cosponsor: Fady Qaddoura (Democratic), Senate - Cosponsor: Gary Byrne (Republican), Senate - Cosponsor: Greg Taylor (Democratic), Senate - Cosponsor: Greg Walker (Republican), Senate - Cosponsor: J.D. Ford (Democratic), Senate - Cosponsor: James Buck (Republican), Senate - Cosponsor: James Tomes (Republican), Senate - Cosponsor: Jean Leising (Republican), Senate - Cosponsor: Jeff Raatz (Republican), Senate - Cosponsor: Joanna King (Republican), House - Cosponsor: Julie McGuire (Republican), House - Cosponsor: Justin Busch (Republican), Senate - Cosponsor: Kyle Walker (Republican), Senate - Cosponsor: La Keisha Jackson (Democratic), Senate - Cosponsor: Linda Rogers (Republican), Senate - Cosponsor: Liz Brown (Republican), Senate - Cosponsor: Lonnie Randolph (Democratic), Senate - Cosponsor: Mark Spencer (Democratic), Senate - Cosponsor: Martin Carbaugh (Republican), House - Cosponsor: Michael Crider (Republican), Senate - Cosponsor: Michael Young (Republican), Senate - Cosponsor: Mike Bohacek (Republican), Senate - Cosponsor: Randy Maxwell (Republican), Senate - Cosponsor: Rick Niemeyer (Republican), Senate - Cosponsor: Rodney Pol (Democratic), Senate - Cosponsor: Ron Alting (Republican), Senate - Cosponsor: Scott Alexander (Republican), Senate - Cosponsor: Shelli Yoder (Democratic), Senate - Cosponsor: Spencer Deery (Republican), Senate - Cosponsor: Stacey Donato (Republican), Senate - Cosponsor: Susan Glick (Republican), Senate - Cosponsor: Travis Holdman (Republican), Senate - Cosponsor: Vaneta Becker (Republican), Senate ## Roll call votes | Date | Chamber | Motion | Result | Yes | No | Other | | --- | --- | --- | --- | --- | --- | --- | | 2025-04-16 | Senate | Senate concurred with House amendments | pass | 39 | 2 | | | 2025-04-14 | House | Third reading: passed | pass | 94 | 0 | | | 2025-02-20 | Senate | Third reading: passed | pass | 47 | 2 | | ## Actions (42) - 2025-05-01: Signed by the Governor (Senate) - 2025-05-01: Public Law 144 (Senate) - 2025-04-23: Signed by the President of the Senate (Senate) - 2025-04-22: Signed by the Speaker (House) - 2025-04-17: Signed by the President Pro Tempore (Senate) - 2025-04-16: Senate concurred with House amendments; Roll Call 466: yeas 39, nays 2 (Senate) - 2025-04-15: Motion to concur filed (Senate) - 2025-04-15: Returned to the Senate with amendments (House) - 2025-04-14: Third reading: passed; Roll Call 443: yeas 94, nays 0 (House) - 2025-04-10: Amendment #1 (Barrett) prevailed; voice vote (House) - 2025-04-10: Amendment #2 (Mayfield) prevailed; voice vote (House) - 2025-04-10: Second reading: amended, ordered engrossed (House) - 2025-04-08: Committee report: amend do pass, adopted (House) - 2025-03-03: First reading: referred to Committee on Insurance (House) - 2025-02-21: Referred to the House (Senate) - 2025-02-20: House sponsor: Representative Barrett (Senate) - 2025-02-20: Cosponsors: Representatives Carbaugh, McGuire, King (Senate) - 2025-02-20: Third reading: passed; Roll Call 203: yeas 47, nays 2 (Senate) - 2025-02-17: Second reading: ordered engrossed (Senate) - 2025-02-13: Committee report: amend do pass, adopted (Senate) - 2025-02-03: Senator Young M added as coauthor (Senate) - 2025-02-03: Senator Carrasco added as coauthor (Senate) - 2025-02-03: Senator Schmitt added as coauthor (Senate) - 2025-01-30: Senators Raatz, Spencer, Taylor G, Walker G added as coauthors (Senate) - 2025-01-30: Senator Tomes added as coauthor (Senate) - 2025-01-30: Senators Deery, Glick, Holdman, Jackson L, Niemeyer, Niezgodski added as coauthors (Senate) - 2025-01-30: Senator Alting added as coauthor (Senate) - 2025-01-29: Senators Clark and Qaddoura added as coauthors (Senate) - 2025-01-28: Senator Charbonneau removed as coauthor (Senate) - 2025-01-28: Senator Brown L removed as coauthor (Senate) - 2025-01-28: Senator Charbonneau added as second author (Senate) - 2025-01-28: Senator Brown L added as third author (Senate) - 2025-01-28: Senator Zay added as coauthor (Senate) - 2025-01-28: Senator Pol added as coauthor (Senate) - 2025-01-27: Senators Buck, Busch, Doriot, Walker K, Yoder added as coauthors (Senate) - 2025-01-23: Senators Alexander, Bassler, Bohacek, Buchanan, Byrne, Dernulc, Donato, Koch, Maxwell added as coauthors (Senate) - 2025-01-23: Senator Randolph added as coauthor (Senate) - 2025-01-23: Committee report: do pass adopted; reassigned to Committee on Appropriations (Senate) - 2025-01-16: Senator Ford J.D. added as coauthor (Senate) - 2025-01-13: First reading: referred to Committee on Health and Provider Services (Senate) - 2025-01-13: Coauthored by Senators Charbonneau, Brown L, Rogers, Crider, Becker, Leising, Hunley (Senate) - 2025-01-13: Authored by Senator Johnson T (Senate) ## Bill text - Engrossed Senate Bill (S): [PDF](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.05.ENGH?format=pdf) - Enrolled Senate Bill (S): [PDF](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.06.ENRH?format=pdf) - Introduced Senate Bill (S): [PDF](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.01.INTR?format=pdf) - Senate Bill (H): [PDF](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.03.COMS?format=pdf), [PDF](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.04.COMH?format=pdf) - Senate Bill (S): [PDF](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.02.COMS?format=pdf) ## Related bills - SB 231: Various corrections matters. (signed) - SB 324: Criminal procedures. (signed) - SB 80: Code publication. (signed) - SB 453: Various tax matters. (signed) - SB 464: Financial institutions and consumer credit. (signed) - SB 371: Workforce matters. (signed) ## Sources - [Engrossed Senate Bill (S) (PDF)](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.05.ENGH?format=pdf) - [Enrolled Senate Bill (S) (PDF)](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.06.ENRH?format=pdf) - [Introduced Senate Bill (S) (PDF)](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.01.INTR?format=pdf) - [Senate Bill (H) (PDF)](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.03.COMS?format=pdf) - [Senate Bill (H) (PDF)](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.04.COMH?format=pdf) - [Senate Bill (S) (PDF)](https://api.iga.in.gov/2025/bills/SB0480/versions/SB0480.02.COMS?format=pdf) ## Related - [SB 231: Various corrections matters.](https://policyrisk.com/state-bill/IN-SB231-2025) - [SB 324: Criminal procedures.](https://policyrisk.com/state-bill/IN-SB324-2025) - [SB 80: Code publication.](https://policyrisk.com/state-bill/IN-SB80-2025) - [SB 453: Various tax matters.](https://policyrisk.com/state-bill/IN-SB453-2025) - [SB 464: Financial institutions and consumer credit.](https://policyrisk.com/state-bill/IN-SB464-2025) - [SB 371: Workforce matters.](https://policyrisk.com/state-bill/IN-SB371-2025) - [Indiana bills](https://policyrisk.com/states/indiana/bills) - [Indiana state hub](https://policyrisk.com/states/indiana) - [All state legislation](https://policyrisk.com/state-bills) Source: PRIA, https://policyrisk.com/state-bill/IN-SB480-2025 (as of 2026-10-17).