July 29, 2021

Texas Law Reduces Prior Authorization Requirements

A Texas law effective  September 1 will eliminate the obligation for doctors to obtain permission or prior authorization from patients’ health insurance plans before administering certain prescriptions or procedures that once required prior authorization. Doctors will have to show that at least 90 percent of their medical orders were deemed medically necessary within the last six months by health insurers to skip the prior authorization process. Texas doctors believe that the new law will reduce delays in patient care and increase access. Texas health insurers have mostly  welcomed prior authorization reform, but criticize the new law for setting too low a threshold for doctors to skip prior authorization.