MS| Bulletin 2025-2 from the Mississippi Insurance Department outlines the requirements for health insurance issuers to annually report aggregated data on prior authorization practices, as mandated by state law, effective April 1, 2025. The report must include specific metrics such as the number of prior authorization requests, denials, appeals, and post-service utilization reviews, along with the most frequently denied services and reasons for denial, and any removed prior authorization requirements. These reports are to be submitted electronically by June 1 each year, are considered public records under the Mississippi Public Records Act, and non-compliance may result in penalties for issuers.
Key Points:
- Health insurance issuers must annually report detailed prior authorization data, including requests, denials, appeals, and post-service reviews, using a standardized form.
- The report requires disclosure of the top ten most frequently denied services and denial reasons, and must note any removed prior authorization requirements.
- All annual reports are public records, and failure to comply with the filing requirements may result in penalties for the insurer.