Easier access to Prescription meds
Sen. Linda Ujifusa and Rep. Teresa A. Tanzi are sponsoring legislation to require study and improved control of health insurers’ use of prior authorization to limit health care.
A
prior authorization (PA) is an approval from a health insurance plan that the
insurer may require before it will cover a service or prescription.
“Insurers
claim that PAs save money and lower prescription drug use,” said Senator
Ujifusa (D-Dist. 11, Portsmouth, Bristol), “but studies do not show PAs help
patients achieve better health, and health care providers believe PAs actually
increase health care costs by preventing timely delivery of medically necessary
care.”
According
to a recent survey of physicians by the American Medical Association, 89%
reported PAs had a negative impact on patient clinical outcomes, 94% reported
PAs delayed necessary care, and 80% reported PAs led to patients abandoning a
recommended course of treatment.
“The Office of Health Insurance Commissioner currently has an Administrative Simplification Task Force that is looking into reducing prior authorization burdens on patients and providers,” notes Representative Tanzi (D-Dist. 34, South Kingstown, Narragansett).
“Our bill simply requires that it focus on
prescription drug prior authorizations because these are by far the most common
PAs faced by primary care providers.”
The
legislation directs the group to issue a report on prescription drug prior
authorization by Jan. 1, 2025.
There is a hearing scheduled for the House bill (2024-H 7623) before the House Health and Human Services Committee Thursday. The Senate bill is expected to have a hearing this spring.
The sponsors encouraged patients who have been
adversely affected by prescription drug prior authorizations to submit
testimony to HouseHealthandHumanServices@rilegislature.gov, using the
instructions found here.