The National Council of Insurance Legislators (NCOIL) 2025 Summer Meeting, held July 16–19 in Chicago, Ill., brought together 405 participants, including 72 legislators from 34 states, seven insurance commissioners and 16 insurance departments. NCOIL is a national legislative organization, represented by legislators who serve on their states’ insurance and financial institution committees, that writes model laws for insurance and financial services.
The ACR is a corporate and institutional partner of NCOIL, with rheumatology and optometry being the only provider groups that currently have that designation. At the meeting, participants discussed several policy issues relevant to rheumatology.
Asm. Erik Dilan (D–N.Y.) and Rep. Forrest Bennett (D–Okla.) held a kickoff conversation on the NCOIL Model Act Regarding Insurers’ Use of Artificial Intelligence (AI), discussing the use of AI in insurance claims, with concerns raised about AI being used to deny medically necessary care.
The Health Insurance & Long-Term Care Issues Committee discussed the NCOIL Prior Authorization Reform Model Act, which includes:
- Standardized electronic prior authorizations to streamline approvals;
- Faster response times for both urgent and non-urgent requests;
- Continuity of care protections, ensuring that approvals for chronic conditions (such as those treated in rheumatology) are not arbitrarily revoked;
- Requirement that qualified personnel must review appeals, reducing inappropriate denials; and
- Transparency requirements, mandating insurers to publish prior authorization statistics and criteria online.
The Committee also heard presentations on hospital charity care and medical debt. A general session about prescription drug affordability boards (PDABs) sparked a productive dialogue among members that included some discussion of new concepts and guardrails for PDABs.
Although not exclusive to rheumatology, broader healthcare reforms discussed at the meeting—such as copay accumulator bans and step therapy limitations—could improve patient access to medications and reduce out-of-pocket costs.
Additional information from the meeting, including presentations and other materials, can be found online.
