Representative Landon Brown presented House Bill 76 to the House Labor, Health and Social Services Committee, asking the panel to require that individuals who make prior-authorization and independent-review determinations for Wyoming patients hold current Wyoming licenses or otherwise be subject to state oversight. Brown said the measure grew from a constituents case in which an out-of-state reviewer denied a hysterectomy authorization and the patient later required emergency surgery.

The bill drew extensive questioning from the committee and several government and industry witnesses. Jeffrey (last name not provided), Commissioner of Insurance, told the panel the state already has a layered appeals process: an internal insurer review, followed by an external independent review organization (IRO) process that the commissioners office can facilitate upon request. He said the department maintains a roster of registered IROs but that many IROs told the department they could not guarantee employing reviewers licensed in Wyoming because Wyomings small population makes it difficult to staff state-licensed specialists. "If the IROs aren't there, if they're not licensed, they're meaningless to us," the commissioner said, adding that imposing a licensure requirement could remove available reviewers and limit consumer access to appeals.

Kevin Bohnenblust, executive director of the Wyoming State Board of Medicine, told the committee the Medical Practice Act frames the "practice of medicine" as occurring where the patient is located and said the board already expects physicians affecting Wyoming patients to hold Wyoming licenses in many contexts. He said the board could investigate such cases and offered to work with the sponsor on narrower drafting or temporary-licensure approaches used during the COVID public-health emergency.

Insurers and industry witnesses including Blue Cross Blue Shield Wyoming and Cigna warned HB 76 could make it difficult or impossible for IROs to identify state-licensed specialists in some fields and could encourage companies to decline doing business in Wyoming. Mike Mosier of Cigna and other insurer representatives urged delay and additional work during the interim. Medicaid and hospital-affiliated witnesses said the existing appeal channels provide access and that many IROs and insurers adhere to federal accreditation standards and rotating panels of specialists.

Retired state employee Ralph Hayes said the appeals and IRO process is available to consumers and observed that, because Wyoming is small, IROs frequently decline to search for Wyoming-licensed reviewers, making a licensure requirement impractical; he warned of unintended consequences including reduced availability of reviewers.

Representative Brown said the bill was intended as consumer-protection legislation to give Wyoming patients recourse in state licensing boards rather than forcing them to pursue complaints in other states. He said he was open to compromise and to working with the Department of Insurance, the Board of Medicine and insurers on targeted drafting changes that would protect Wyoming patients without eliminating the reviewer pool.

After public and registered-lobbyist testimony the committee closed comment and did not move HB 76. Committee members asked staff and agency witnesses for follow-up information, and the sponsor agreed to work with stakeholders. The session adjourned with the committee scheduling remaining business for the next meeting; no formal motion or vote on HB 76 occurred during this hearing.