Sen. Tyler Johnson: Indiana patients deserve prior authorization reform

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One thought on “Sen. Tyler Johnson: Indiana patients deserve prior authorization reform

  1. Data shows that Prior Authorization (PA) does not reduce overall costs or improve quality of care. PA is a “speed bump” to slow utilization. Most denials are eventually approved, but after lengthy, complicated, costly, and often dangerous delays. Patients have little insight into what hospitals and physicians must go through to get them the care they need. There is lack of transparency regarding criteria used by payers for approval. Clinical practice guidelines are published by a variety of medical professional societies giving expert, evidence base guidance to clinical decision making. But even these tools are limited (only about 20% of recommendations are supported by multi-center randomized clinical trials), the majority of clinical decisions are based on individualized clinical judgement supported by applicable clinical evidence. IN should not have to reinvent the wheel. States like TX, VA, MD, IL, CO, OK, and others have already passed laws restricting PA. The US Congress has passed legislation to restrict PA in Medicare Advantage plans. Even the state of IN has considered laws to limit PA that involves state employees. The discussion regarding PA has been going on for more than 10 years. The ongoing “discernment” by payers is nothing more than foot dragging.

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