Senator Hoylman Introduces Prior Authorization Reform Bill
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With negotiations for the State Budget expected to wrap up in the next few weeks, MSSNY’s advocacy focus for the end of the Legislative Session will shift to working with several groups in strong support of legislation (A.3789, Weprin/S.7297, Hoylman-Sigal) which would make significant progress toward addressing health insurer-imposed prior authorization (PA) delays. It would: require that health plan utilization review criteria be evidence-based and peer reviewed, reduce the insurer timeframe for reviewing PA requests; and limit when an insurer can withdraw or repeat a previously granted PA. The standards within this bill are based on recommendations made by several respected health care advocacy organizations to improve patient care.
Please contact your Assembly members and Senators through MSSNY’s Grassroots Action Center (GAC) to let them know you support passage of this bill THIS YEAR!
Unnecessary delays in the authorization of prescriptions, tests, or procedures can cause needless anxiety for patients already stressed by the uncertainty regarding their condition. An Annals of Internal Medicine study concluded that for every hour a physician spends on delivering care to a patient, two more are spent on administrative tasks. Moreover, a recent survey of physicians by the American Medical Association (AMA) reported that 94% of responding physicians said that the prior authorization process delayed patient access to necessary care and nearly 90% of the respondents indicated that prior authorization led to somewhat, or significant, negative outcomes.
Patients with chronic conditions have complex medical needs, and their health depends on following strict treatment regimens. Timely access to treatment and medications is critical to maintaining these regimens. PA requirements may increase their risk of lapsing treatment or exacerbating progression of their disease as a result of these delays and can have a negative effect on their lives and health outcomes.
We will update members as the bill progresses over the next several weeks.
