NCOIL adopts prior authorization model bill
At their annual meeting last week, the National Council of Insurance Legislators (NCOIL) adopted a prior authorization reform model bill (PDF). The original model bill was brought to the committee for consideration by Mississippi State Senator Walter Michel early this year, as Sen. Michel had recently enacted a reform law in his state.
NCOIL’s Health Insurance and Long-Term Care Issues Committee debated the bill’s provisions over the last year, receiving feedback from stakeholder groups, including the AMA, over their last four meetings, in interim phone calls and through numerous comment letters.
The resulting bill addresses:
Transparency of prior authorization requirements and clinical criteria;
Automation;
Response times;
Clarity on reasons for denials;
Length of prior authorization approvals;
Continuity of care; and
Other important pain points for patients and physicians in the prior authorization process.
Of note, despite some pressure to back down, NCOIL took a strong stance on a 24-hour response time for urgent care. As stated in final remarks to the committee, the AMA greatly appreciates the commitment of committee members, including Chairman Michael Sarge Pollock of Kentucky and Sen. Michel, to advancing this model at NCOIL. While the AMA had remaining changes it would have liked to see in the final bill, this new model legislation will serve as a great foundation for state reform efforts.
New AMA model bill for kratom and tianeptine
The AMA considers unregulated kratom and tianeptine as dangerous substances that represent serious public health concerns. A new AMA model bill—along with an illustrative set of legislative examples—is now available to support medical society advocacy in their 2026 state legislative sessions. The AMA model bill provides a framework for medical societies to generally prohibit the production and sale of kratom product or tianeptine product for human use that has not been approved by the Food and Drug Administration. The bill also provides a range of civil penalties for violations.
The legislative template (PDF) provides examples of additional provisions, including:
Restrictions on the possession, distribution, sale and manufacturing;
Labeling and other disclosure requirements; health and safety disclaimer(s);
Age restrictions;
Allowable levels of active ingredients, mitragynine and 7-OH; and
Scheduling as a controlled substance.
Medical societies interested in learning more, including obtaining a copy of the model bill, should contact the AMA’s Daniel Blaney-Koen, JD, senior attorney, Advocacy Resource Center.
More articles in this issue
- Nov. 21, 2025: Advocacy Update spotlight on the 2025 AMA Interim Meeting
- Nov. 21, 2025: Medicare Payment Reform Advocacy Update
- Nov. 21, 2025: National Advocacy Update
