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Read. Follow. Verify.Missouri bill exempts health care providers with 90% approval rates from prior authorization requirements
Last action · March 3, 2026: Hearing Conducted S Insurance and Banking CommitteeSponsor: Ben Brown
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What This Bill Would Do
s and utilization review entities are prohibited from requiring from health care providers unless the provider's approval rate fell below 90% in the most recent evaluation period. Insurers must notify providers within 25 days of a determination, maintain an online prior authorization portal, establish an appeals process, and honor existing prior authorizations without denying or reducing payment.
Determines whether medical professionals must seek advance insurance approval for patient treatments, altering administrative burdens and timelines for health care delivery across the state.
Who It Would Affect
Groups the bill's text would affect if enacted, as described in the record. Being affected is not a position for or against it.
Health care providers
Providers are relieved from obtaining prior authorization for services or overall care if their approval rates meet or exceed 90%.
Health carriers and utilization review entities
Insurers and review entities must track provider approval rates, issue determinations within 25 days, maintain online portals, and establish provider appeals processes.
MO HealthNet
Services not provided through a managed care organization are explicitly exempted from the act.
Key Facts
You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.
Frequently Asked Questions
When is a health care provider exempt from prior authorization requirements?
What obligations do health carriers have under this legislation?
Are all state health programs covered by this bill?
What else do you want to know?
News Coverage
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Votes, people, money & the original sourceWhere This Stands
Currently in committee. The next step in the legislative lifecycle is Floor Vote.
Procedural history
4 actions- Mar 3, 2026SenateHearing Conducted S Insurance and Banking Committee
- Jan 8, 2026SenateFloorSecond Read and Referred S Insurance and Banking Committee
- Jan 7, 2026SenateIntroducedS First Read
- Dec 1, 2025SenatePrefiled
Version history
Only one version on file - nothing to compare yet. The text on record is the 4611S.01I - Introduced version. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Repeated Legislative Pursuit
This bill is identical or similar to numerous prior legislative proposals filed in Missouri from 2023 through 2026, indicating a sustained multi-year effort to reform prior authorization rules.
Connected Entities
Sources
www.senate.mo.gov
Analysis Score
0–100- Significance75How much this matters to a regular citizen
- Controversy50Intensity of disagreement among stakeholders
- Entertainment5Compellingness for a non-policy-wonk reader
- Buzz40Current news / social attention level
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