S.B. 319 Health Insurance Preauthorization Amendments: transcript

Senate Business and Labor Committee, Feb 27, 2026

House Health and Human Services Committee, Mar 4, 2026

1. Rep. Katy Hall (committee chair)54:15

   We will get going, um, with Senator Johnson and eight, uh, SB three 19.

2. Sen. John D. Johnson54:22

   I apologize. Committee, I, I had two other presentations over in the education committee. I I appreciate your, uh, your consideration. Uh, chair members of the committee thank you for the opportunity to present SB three 19. I want to begin with a story a physician told me, and I actually wrote an op-ed about this in the paper. Uh, he had a patient diagnosed with pancreatic cancer. He determined the appropriate chemotherapy and prescribed a standard anti anti-nausea medication so she could tolerate the aggressive treatment ahead. It was not experimental, it was not unusual. It was the right medical call, but it did not start right away. And, uh, he actually came, came to me and talked to me about some of the stuff we'd done last year with prior authorization, which simply was a, was a transparency bill. And, and, and this is kind of a continuation of the same thing. The insurer required, uh, prior authorization, not unusual, right? The request triggered review, follow up documentation, and delay for patient beginning cancer treatment. That waiting time is not abstract. It, it really matters. The physician was, uh, Dr. Mark Lewis. His experience is not isolated. It is common. I actually had him on my podcast, and we talked about this quite a bit. Prior authorization was designed to prevent, misuse and protect policy holders. That purpose is legitimate. But what began as a targeted safeguard has expanded into a broad administrative system affecting routine medications, imaging, and outpatient care that are already supported by established clinical guidelines. A 2023 survey from the American Medical Association found that 94% of physicians report prior authorization delays necessary care, nearly one in three report delays of several weeks or longer. For patients with cancer, heart disease, or serious chronic illness, those weeks can mean complications, additional procedures, and preventable costs. When oversight becomes opaque and unpredictable, it stops protecting patients and starts shifting risk and stress onto families. This bill establishes enforceable standards, and without eliminating prior authorization, there are six provisions. First, transparencies, uh, insurance must post their authorization requirements publicly in plain language. Utah's should not have to guess what criteria determine whether their care is approved. Second, AI disclosure, if artificial intelligence is used to review, to review authorization requests, that use must be disclosed to the patient, the provider, and the insurance department. The substitute bill adds a statutory definition of artificial intelligence. That includes generative ai. When algorithms influence coverage, decision transparency is required. And, and, you know, I actually started this bill, uh, by, you know, I, I read so many of these prior auth bills across the country that simply banned AI and technology. And I think that's a mistake in this space. I, I think that actually is the future. And I plan on, uh, uh, during interim working, working towards a, a very well-defined, uh, structured framework for, for using ai, because I think it could actually speed up the process, and it could actually, you know, there's two types of risks that occur, right? There's, we, we pay for things that we shouldn't pay for. That's one type of risk. And then we don't pay for things that we should pay for. So there's two types of risks there that we need to balance. But, but I, but I think, you know, the balance has to be on the side of, of the patient too, and the health and welfare. So I, I, I think both of those are important, and I, I, I, I'm hopeful that we, uh, that we can move forward with that. Okay? The third thing is firm timelines. The substitute established seven calendar days for standard request, and 72 hours for urgent care. Insurers are free to review. They are not free to stall. These are actually in, in line with, with published guidelines for Medicare right now. So, I, I, you know, those are things that I, I think we can agree on. Uh, fourth, independent medical judgment. Clinical denials must be made by an individual with knowledge of the relevant condition, who exercises independent judgment. The bill explicitly prohibits relying solely on recommendations from any other source, including automated systems. And, and in, in AI speak, that's really the human in the loop, right? At some point, we have to be able to talk to a human fifth, continuity of care for chronic and long-term conditions, authorizations must be valid for a minimum of 12 months. Patients with stable treatment plans should not be forced to, uh, re-litigate them every few months. Sixth, public reporting approval rates, denial rates, appeals outcomes, and processing times will be reported to the insurance department and published the substitute adds prescription drugs to that reporting and requires average and median processing times prior authorization remains available as an insurer tool. Insurers retain full clinical review authority, oversight of misuse and experimental treatments continues. This bill does not require rubbish stamp approvals. It does not control formulary or benefit designs. It does not create new coverage model mandates. What it does is require that when insurers exercise this authority, they do so transparently, promptly, and with accountable medical judgment. The, uh, first substitute, uh, which I hope we can adopt, uh, today makes four substative changes from the introduced bill. The standard decision timeline moves from five business days to seven calendar days. This aligns with federal standards and addresses implementation concerns raised during review. The bill now includes statutory definition of artificial intelligence, uh, and explicitly including, uh, generator of ai. This ensures the disclosure requirement is not evaded through narrow interpretation. Prescription drug drug authorizations are now included in mandatory reporting, and the reporting requirement add average in median processing times. The introducing, uh, bill excluded prescription drugs. The substitute closes that gap. Dr. Lewis's patient eventually received her me medication, a after navigating delays and appeals. But timely care should not depend on persistence or, or on having a physician willing to fight through an opaque process. Utah families deserve transparency that deserve timely decisions. They deserve decisions made by accountable professions. SB three 19 makes those expectations enforceable under Utah law. I'm happy to answer any questions. And that concludes my presentation. Thank you very much.

3. Rep. Katy Hall (committee chair)1:01:03

   Thank you, Senator. We'll bring it back to the committee for any clarifying questions. And you were speaking to sub Juab? Yes, correct. Okay.

4. Sen. John D. Johnson1:01:11

   So I'm hoping we can adopt that, that, that a a actually had talked to a number of the insurance companies that wanted, wanted some changes. Uh, so, okay.

5. Rep. Katy Hall (committee chair)1:01:21

   All right. Well, not seeing any questions from the committee at this time. We'll go to the public for any comment. Is there anyone that wants to comment on this? Kay, come on up and make sure you introduce yourself and who you represent. Thank you.

6. Michelle McOmber, Utah Medical Association1:01:44

   Thank you, Madam Chair, Michelle McCumber with the Utah Medical Association. We appreciate the senator running this, uh, prior auth bill. We, uh, the, you a, uh, ran a prior auth bill about five, six years ago. It didn't get, uh, enough stuff in the bill, and we do appreciate what he's put in this bill to move this forward, this conversation forward. Um, it, it does, uh, make for more transparent process. Um, it does, uh, put timelines in which makes sense. And it also does allow for, uh, you know, a definition of urgent care so that these patients that need care can get the care that they need. And we think if prior auth could be done in a more efficient way, we would save lots of money on the prior auth process from the provider side of things and from all sides of, of the equation, so that that money could be spent on actually caring for the patients. So we would urge you to support this bill. Thank you.

7. Rep. Katy Hall (committee chair)1:02:40

   Thank you. Thank you.

8. Kim Frost, Regence Blue Cross Blue Shield1:02:42

   Um, Kim Frost, I'm with Regions Blue Cross Blue Shield, and as Senator Johnson mentioned, we've been working with him over the past week on this bill, and we appreciate his collaborative approach. Um, we understand the challenge that there is and that he faces in trying to strike a balance between all of the different stakeholders. Um, and as an insurer, I know you all understand that prior authorization is an important tool that we use to ensure medical necessity, um, prevent unsafe, and low value care. And this is all determined by our clinical team, and it helps us to control costs for Utah families and individuals. At the same time, we want that process to be efficient and we want it to work for, um, all of our members. So we appreciate his willingness to take some of our suggestions. Not all of them, but some of them. And so we really appreciate that collaboration that we've had with him. Um, one thing I also wanted to note was that Senator Johnson and I have also discussed that Regents Blue Cross Blue Shield has signed on to commitments that were made by Blue Cross Blue Shield Association and a hip to simplify the prior authorization process. Um, and we plan to do that by accelerating decision timelines, increasing transparency and expanding access to affordable quality. Um, care we ran out of time this session, but we wanna work on that over the interim and continue to try to improve this process for our members and our Utah families. Thank you.

9. Rep. Katy Hall (committee chair)1:03:58

   Thank you. Maryanne Martindale,

10. Maryann Martindale, Utah Academy of Family Physicians1:04:01

    Utah Academy Family Physicians. Um, we've been working with, um, Senator Johnson on this since the beginning, um, as along with UMA and and sum on some of the other organizations. So we really appreciate his collaborative efforts. Um, we did have the substitute and we agreed on the majority of them, um, which is, you know, that's what we do. We negotiate to get a good bill, and I think that we've landed on something that we can all feel, feel good about and will make a difference in prior authorization. Um, what I hear from my physicians, this is one of their biggest complaints about administrative burden related to prior authorization and the lack of transparency around it. So they understand what they're being told. So we think this is gonna improve that, and we encourage your support. Thank you.

11. Rep. Katy Hall (committee chair)1:04:41

    Okay. Thank you. Go ahead.

12. Ava Szajnuk, Utah Rare Disease Advisory Council1:04:44

    My name is Ava Zik. Um, I'm an 18-year-old rare disease patient and advocate representing the Utah Rare Disease Advisory Council. And I'm speaking in favor of the substitute. I grew up in and out of hospitals with severe neurological symptoms that doctors initially struggled to diagnose like many rare disease patients. The hardest part was not just the illness itself, but the long process of proving that I needed care. One of the most significant barriers was prior authorization, even when my doctors agreed on what treatment or imaging I needed, care could be delayed for weeks while insurance approvals were processed. When you live with a complex condition, those delays are not just administrative, they mean more pain, more uncertainty, and worsening symptoms for rare and undiagnosed patients, especially treatment plans are already over complicated, repeating the same prior authorization requests over and over for stable care creates unnecessary obstacles for both patients and physicians. SB three 19 makes the prior authorization process more transparent, efficient, and accountable, requiring clear authorization criteria. Reasonable turnaround times and protections for patients with chronic conditions will help ensure that care decisions are guided by physicians and patient needs, not by bureaucratic delays. The 12 month prior authorization protection especially allows chronically ill patients like myself to maintain the continuity of care that is often the difference between stability and crisis. I respectfully urge the committee to support SB three 19 so that Utah patients with rare and complex conditions can spend less time fighting paperwork and more time focusing on their health. Thank you all for your time, especially for Senator Johnson as well. Thank you.

13. Rep. Katy Hall (committee chair)1:06:15

    Thank you. Ava. We'll go online to Justin Case, Justine case. And just a reminder, if you're joining us online, make sure you turn on your camera and tell us who you are and where you're calling from.

14. Justine Case, Utah Rare Disease Advisory Council1:06:33

    Thank you. Um, my name is Justine Case. I'm also a member of the Utah Rare Disease Advisory Council. I live in Draper, and I'd like to thank the senator, uh, Senator Johnson for this practical and meaningful bill. We support the current substitution and especially appreciate the seven day turnaround, which is in compliance with current federal standards. Whenever I'm talking about rare disease to policymakers, I like to emphasize that it's really 10% of the population who are impacted by rare disease. And we are high users of medical services, and we frequently experienced delays due to pre-authorization practices. Senator Johnson cited the a MA study that found one in three physicians have seen adverse outcomes due to prior authorizations. And I'd just like to offer that in my family. I currently have two family members who are experiencing this right now. Um, one is one of my parents, the other is one of my siblings, and one's increased pain, the other at increased risk of infections because both of them are missing out on prescribed treatments that were developed and have already been proven helpful in their very unique rare cases. But prior, prior authorization is stalling their access to their established care plan. So we really appreciate this being addressed by, um, Senate Bill three 19. And I just, I ask that you please, um, support this bill because it offers a streamlined process standardization and better transparency and all around us a better approach for providers, patients, and health insurers. Thank you for your consideration.

15. Rep. Katy Hall (committee chair)1:08:05

    Thank you, Justine. We'll go next to Krista Sean Rock maybe. There we go. All right. Go ahead Krista.

16. Dr. Krista Schonrock, Select Health1:08:35

    I'm sorry that took a moment. Hi, I am Dr. Krista Schrock. I'm an internist by trade and, uh, spent many years in primary care and currently practice in the InstaCare. And I'm a senior medical director at Select Health. I, I do wanna thank you for, um, considering some of those changes in those discussions and, and, and I don't disagree with much of what's in the bill. However, there are still some concerns. I, uh, we do support the transparency, we support the reporting with that I have concerns about transparency in lay terms. We would like that these policies remain in, um, in more technical terms to encourage that discussion with their provider. These are all in terms that are understandable by the providers, and we, we would, uh, hesitate to have the communities reading them, trying to interpret them, uh, on their own without the guidance of a professional with that. Um, I also hesitate on, uh, the 72 hour turnaround. I agree. Urgent issues are urgent, including that anti-nausea and the chemotherapy with that 72 hours, however, uh, limits it over the weekend of being able to get a response from the provider or even get a request to a provider for more clarification, even if it's, I think I have all the information, but it doesn't quite make sense. And so we just wanna have that conversation. Um, two to three business days would make more sense around that. And then, uh, and keeping in mind that emergent, um, treatments aren't how bound to a prior auth, so we're not talking about emergent things. And then, um, you know, the turnaround time is in line with federal, um, guidelines, and we currently have an average turnaround time of five days already. Um, and, uh, with a fair number of those in the portal and auto approved immediate turnaround time. So we're supportive of the, the, um, changes that you just made. Um, I think, however, there's still just a few things in this that are, uh, a little glitchy, um, and could be, could be problematic down the road and would appreciate some time to maybe extend this and, and have a thought, more thoughtful conversations rather than trying to, to push it through and, and make sure that we had something that was, um, not going to inadvertently affect our providers and, and, um, or increase the cost to our communities. I don't wanna have to call a provider and say, you have till four o'clock tonight to get back to me and interrupt their patient flow. With that. I wanna be able to give the provider appropriate time, um, to, to answer some clarifying questions.

17. Rep. Katy Hall (committee chair)1:11:31

    All right. Thank you, Krista. Okay. I am not seeing any other commenters, so we'll bring it back to the committee for any discussion or motion. Representative fit Just a question, please. Yes, Go ahead. Thank you.

18. Rep. Jake Fitisemanu1:11:56

    Um, the bill mandates that an insurer, Can you pull the mic down too? Thank you. Sorry. Uh, the bill mandates that an insurer notify, um, whether or not artificial intelligence is being utilized in the process for, um, processing, uh, these requests. Uh, is it also the intent for enrollees to be notified whether they're individual, um, decisions, uh, whether AI was involved in individual approvals or denials, uh, of pre-authorization requests,

19. Sen. John D. Johnson1:12:27

    Right. The, right now that's a disclosure to the, to the doctors and stuff.

20. Rep. Jake Fitisemanu1:12:33

    And, and what, what's your thought on that? Is that, is that something that you, I I guess I'm just thinking of how this Im might impact, um, appeals process, right? It like at what part, at what point if AI makes a decision about my, uh, and maybe it's a wrongful, um, denial, um, at what point does a human, you know, actually get to review, uh, what that was and, and who do I appeal to? I mean, where does that lie if AI made that decision?

21. Sen. John D. Johnson1:13:01

    So, so that is always the human in the loop before a denial can happen. Okay. So the human has to be able to, to talk to it and, and you know, the thought is kinda like, if, if they want to prove something and they want to use AI to do that, I, I think that's great, right? The faster that can happen, you know, having, having that feedback, and that's what I'd really like to define better in a, in an AI specific bill. And, uh, you know, that that's part of what we were talking about with, uh, blue Cross in terms of, you know, getting those other guidelines in there. If you look at, if you look at what, what she talked about today from Blue Cross is those, those are things that are really putting us in, in line for that. And really the disclosure of this data is putting us in line with that too, so we know what normal is, right? And that's, that's kind of the start of it. But, but right now, a denial cannot happen without the human. Yeah. And there's nothing in this bill that changes the current procedure or process for no appealing. Thank you.

22. Rep. Katy Hall (committee chair)1:14:07

    Thank you. Representative Gricius, Is it appropriate to make a motion? It is. Okay.

23. Rep. Kristen Chevrier1:14:13

    I would like to make a motion to adopt sub one. Perfect. That motion is in order. Do you wanna speak to it? SB three 19? No, I, I just like the bill and I, I think we should pass it out.

24. Rep. Katy Hall (committee chair)1:14:26

    Okay. Motion is to adopt, um, oh, we'll go to the make, uh, to the sponsor for on that motion. I'll, alright. Not seeing any comments from the committee. So the motion is to adopt first substitute SB three 19. All in favor say aye. Aye. Aye. Any opposed? That motion passes. Do you wanna keep going? Yes.

25. Rep. Kristen Chevrier1:14:48

    I would like to make a motion to pass out favorably senate bill three 19 sub one.

26. Rep. Katy Hall (committee chair)1:14:57

    Right. That motion is in order. Do you wanna speak to that one?

27. Rep. Kristen Chevrier1:15:00

    No. Thank you for letting me practice motions though.

28. Rep. Katy Hall (committee chair)1:15:03

    You're welcome. All right. I am not seeing any comments from the committee. We'll take it to the sponsor again. Waive. All right. Thank you. And we will, so the motion is to pass forward with a favorable recommendation SB three 19 as substituted. All in favor say aye. Aye. Aye. Any opposed? That motion passes unanimously. Congratulations. Thank you very much. I appreciate it. All right. And again, this is our last health and Human Services meeting. Thank you all for being wonderful, wonderful committee members and staff. We're so grateful for that. Um, thank you. We'll take one final motion. Motion to adjourn. Motion to adjourn. Non debatable. All in favor say aye. Aye. Any opposed? Motion passes. We are done.

Senate floor, Mar 2, 2026

1. Sen. John D. Johnson11:50

   and timeliness and health insurance prior authorization without eliminating utilization review. This bill does not dismantle prior authorization. It disciplines it. Prior authorization was designed as a cost control safeguard. The purpose remains legitimate. However, over time, it has expanded into a broad administrative process affecting routine medications, imaging, and outpatient services. Physicians across Utah report delays unclear criteria, repeated, uh, reauthorization cycles. And so the this bill, uh, is, is trying to approach this one step at a time. So it has transparency, uh, requirements. The bill requires insurers to post all prior authorization requirements on their website in clear, understandable language. Update posted requirements when modifications occur, disclose whether artificial intelligence is used in the review of authorization request. Once an insurer receives the necessary information, they have five business days for standard requests, 72 hours for urgent care services. Of course, emergencies are, are, are already, uh, covered. If information is missing in an urgent case, the insurer must promptly notify the provider and then decide quickly once the additional information is received. This is not a mandate to approve. It's a mandate to decide, uh, for adverse determinations based on clinical or medical necessity. The decision must involve independent medical judgment. The reviewer must be appropriately licensed. The reviewer may not rely solely on recommendations from another source for chronic or long-term conditions. Authorization validity periods may not be less than 12 months. In most cases, outpatient services may not be less than six months. Flexibility remains if a drug is ineffective. It is a better ther if a better therapy is available or if less costly. Equally effective alternatives exist. So the in insurers, and this is the main part really, uh, that they, they must, uh, report approval and denial rates, appeal outcomes, processing timelines, data related to prescription drugs. And so this bill, uh, does not eliminate prior authorizations, does not remove insurer's ability to control cost. It is not require approval of inappropriate care. It does not create new state spending. It states it sets process standards. Uh, and so, you know, part of what I wanted to do this this year was actually when I went out and looked at prior authorization across the country. I found that, uh, many of the bills actually, uh, banned the use of ai. And I, I, I thought that was a mistake. I think it that can actually help speed up the process didn't really have time to, to go through a whole, uh, framework for how these ais would work. And so what we simply said is they have to reveal it, but they have to have a, a human in the loop. And so that's basically what the bill does. And I'm open for questions.

2. Senate President Winterton (presiding)15:09

   Thank you for the presentation. Senator Johnson looking for questions to your bill. Seeing no questions. I'll go back to you for a motion.

3. Sen. John D. Johnson15:26

   I move that SB three 19 health insurance pre-authorization amendments. Uh, be read a third time.

4. Senate President Winterton (presiding)15:32

   Thank you. The question is, shall Senate Bill three 19 be read A third time Roll call Vote. Senator Vickers

5. Unknown speaker (roll call)15:37speaker not certain

   Baldy Lewin Bramer Bus Cullimore Escamilla Fillmore Grover Harper Kinins Aye. Ipson Aye. Johnson. Aye. Juab McKay. Mikel Milner. Milner Musselman Owens Aye. Pitcher? Aye. Lum Rebe. Aye. Sandal Stevenson Stratton Bickers Weiler Aye. Wilson Winterton, president Adams

6. Senate President Winterton (presiding)16:35

   Senate Bill three 19, having received 22 yay votes, zero Naval seven, seven being absent will be read for a third time.

7. Senate President Winterton (presiding)16:43speaker not certain

   Is there anyone else who wishes to encircle on second or on third? Okay. If not, we're gonna run the board. Oh, wait a minute. Do we have a standing committee report? We need a rules committee report to read in. Well, we also have to introduce, Okay.

Senate floor, Mar 3, 2026

1. Sen. John D. Johnson1:43:01

   transparency, accountability, and timeliness to prior authorization. Prior authorization was created to prevent misuse and control costs That purpose remains legitimate. Oversight matters, but over time, the process has expanded far beyond rare or experimental treatments. Today. It affects routine medications, imaging, and outpatient care, often with unclear criteria and unpredictable timeliness. When a patient is facing cancer, heart disease, or serious chronic conditions, waiting on paperwork is not a minor inconvenience. It creates stress, uncertainty, and in some cases, avoidable complications. The bill does not eliminate prior authorizations. It disciplines it. First, insurers must clearly post their authorization requirements in plain language. Patients and providers should not have to guess what rules apply. Second, if artificial intelligence is used in reviewing requests that must be disclosed. When algorithms influence coverage decisions, transparency is required. Third, the bill sets firm time timelines. Five business days for standard request and 72 hours for urgent care. Insurers are free to review. They're not free to stall. Fourth, when care is denied on clinical grounds, the decision must reflect independent medical judgment by a licensed professional. It cannot rely solely on automated screening or UNEC unchecked recommendations. The bill also reduces repetitive reauthorization cycles for chronic conditions and strengthens reporting. So approval rates, denial rates, and processing times are publicly measurable. This is not anti insurance. It's proac accountability. SB three 19 preserves cost oversight while ensuring that the process is transparent, timely, and grounded in professional judgment. I, I respectfully ask for your support. Thank you. Looking for discussion.

2. Sen. J. Stuart Adams (presiding)1:44:58

   See none to you for a motion.

3. Sen. John D. Johnson1:45:00

   I move that, uh, SB three 19 pass.

4. Sen. J. Stuart Adams (presiding)1:45:04

   Thank you. And the question is, shall Senate bill three 19 pass. Roll call

5. Senate clerk (roll call)1:45:08

   Vote. Senator Vickers Baldy Aye. Lewin Brammer Aye. Bus? Aye. Comore. Escamilla Fillmore Aye. Grover Aye. Harper Kinins Aye. Ipson Johnson Juab McKay Mikel Milner Musselman Owens pitcher Plum Rebe Sandal Stevenson Stratton Bickers. Weiler Aye. Aye. Wilson Winterton.

6. Sen. J. Stuart Adams (presiding)1:45:56

   President Adams Aye. Senate Bill three 19. Having received 28 a votes, zero nay votes, one being absent passes, this body will be sent to the house for their consideration.

7. Sen. J. Stuart Adams (presiding)1:46:10

   First substitute Senate bill 3 24. First substitute Senate bill 3 24. Outcome based investment grant. Pilot framework. Senator Musselman. Senator Musselman.

8. Sen. Karen Musselman1:46:29

   Thanks Mr. President. Um, I'm gonna just give a little bit, maybe a different,

House floor, Mar 4, 2026

1. Unknown speaker2:07:01speaker not certain

   Substitutes and Bill three 19 Health Insurance Preauthorization Amendments by Senator Johnson. This bill was heard in Health and Human Services with a vote of 9 0 5

2. Speaker (presiding)2:07:16

   Representative Hall.

3. Rep. Katy Hall2:07:17

   Thank you Mr. Speaker. Uh, motion to circle. Motion is to circle. We'd like to speak to it. Uh, I'm just waiting for some notes on it.

4. Speaker (presiding)2:07:27

   Okay. The motion is to circle discussion to the motion. See none. All in favor say aye. Aye. Aye. Opposed say no. Motion carries a Bill. Bill is circled matter.

House floor, Mar 4, 2026

1. Speaker (presiding)2:24:23

   Uh, we'll place the motion to Uncer first substitute SB three 19. All in favor say aye. Aye. Any opposed? Roll. That motion passes the bills encircled and before the body to you, Representative Hall. Thank

2. Rep. Katy Hall2:24:34

   You Mr. Speaker. So, uh, SB three 19 addresses the growing administrative burden and delays that are caused by pre-authorization process. Um, it rec we recognize that prior authorization originally served a legitimate purpose, but, um, to prevent misuse and ensuring treatments met clinical standards. But the process has expanded beyond the original intent and now affects routine medi medications, imaging, and standard treatments causing delays in care. Um, so the key reforms in SB three 19 are transparency. So first thing, it requires insurers to publish prior authorization requirements and approval statistics. Um, the other thing is timelines that establishes a clear decision deadline so that patients aren't left waiting indefinitely. Um, it provides medical oversight requires denials based on a medical necessity that involve independent medical judgment from a licensed professional and not just from automated systems. And it ensures continuity of care, um, ensuring that prior, prior authorizations for chronic or long-term conditions remain valid enough for treatment plans to work. The overall goal of this legislation is to restore balance between physicians, patients, and insurers, and allow doctors to focus on practicing medicine, ensuring that patients receive timely care and manage, and that the insurers ma and then maintains the insurer's ability to manage costs responsibly. Um, there was a lot of work put into this by all the stakeholders and I am happy to take any questions.

3. Speaker (presiding)2:26:15

   Thank you. Representative Hall discussion to the bill? None. Back to your Representative Hall for summation. I'll waive summation has been waived. Voting will now be open on first substitute SB three 19. Senator Vickers, this is the last chance to unc any bills. Thought I said representatives, but if I said Senator Vickers, I ought to be shot. So good intern said I might've saw, said Senator Ipson. That's a huge apology. I love our Senator Ipson, but I representatives See now present Representative Shallenberger would to vote. Representative Shallenberger would like to vote. See now present vote voting is now closed. First substitute SB three 19 passed this body with 69 Yes. Votes one no vote will be sent to the Senate for further consideration. Let's go to Representative Shallenberger,

4. Rep. David Shallenberger2:28:24

   You, Mr. Speaker. Motion to encircle Senate bill 2 81.

5. Speaker (presiding)2:28:28

   Thank you representative. That motion is in order. Would you like to speak? Uh, go ahead and place the motion.

6. Unknown speaker2:28:32speaker not certain

   The motion before is the House UNC Circle third

Senate floor, Mar 5, 2026

1. Senate President (presiding)32:51

   Senate Senator Johnson. Motion to Concur. We have a motion to concur. You want to talk about the changes?

2. Sen. John D. Johnson32:57

   Yeah. There, there were a few, uh, date changes that the insurance companies wanted. Uh, I negotiated those right after the, the presentation here and then I, I made tho that amendment in the house Committee.

3. Senate President (presiding)33:16

   Thank you for the explanation. Seeing no discussion, I'll place the motion. All in favor of the motion to curses say aye. A a. Any opposed Will the motion passes First substitute Senate Bill three 19 has been read three times. The question is, shall it pass? Roll call Vote. Senator

4. Unknown speaker33:32

   Baldy Lewin Brammer Bus and I Escamilla Fillmore Aye. Grover Harper. Aye. Hankins. Ipsen Johnson. Aye. Quan McKay Hel Aye. Milner Musselman Owens pitcher Alum Rebe Aye. Sandal Stevenson Stratton Vickers Aye. Weiler Wilson. Aye. Winterton President Adams

5. Senate President (presiding)34:27

   Aye. First substitute Senate Bill three 19, having received 26 yay votes, zero nay votes, three being absent, passes his body and will be returned to the house for the signature of the speaker. Senator Stevenson,

6. Senate President (presiding)35:04

   Okay. We're gonna go to the second reading calendar.