LB77 – Adopt the Ensuring Transparency in Prior Authorization Act and Provide for Insurance and Medicaid Coverage of Biomarker Testing

NELawState

Date Passed

6/6/2025

Effective Date

1/1/2026

Summary

Comprehensive prior-authorization reform with explicit AI provisions: adverse determinations require physician or clinical-peer review, AI may not be the sole basis for medical-necessity decisions, AI use must be disclosed to regulators, providers, enrollees, and the public, and automated utilization-management systems are subject to audit.

Healthcare Implications

Requires human clinical accountability in utilization management while adding specific transparency and audit obligations for insurer and UR-agent AI use. Payers and vendors must disclose AI use and prepare for regulatory review; providers and patients gain clearer protections against AI-only adverse determinations.

Operational Implications

  • Adverse PA determinations must be made by a physician (or clinical peer); AI may not be sole basis for medical-necessity decisions (Sec. 12).
  • Insurer must disclose AI use to department, each network provider, each enrollee, and on public website (Sec. 12).
  • Department may audit UR agent's automated UM system at any time, including via third-party contractor (Sec. 12).

Impact Level

High

Keywords

Safety & Risk; Transparency & Governance; Clinical Quality & Efficacy

Stakeholders

Payers & Purchasers; Providers & Health Systems; Patients & Public; Regulators & Government