Ind. Senate Republicans: Johnson Authors Patient Protection Bill
State Sen.
Senate Bill 3 addresses multiple areas of concern with the current prior authorization system, with an emphasis on changing the system so it prioritizes patients.
The term "prior authorization" refers to a practice used by insurance plans to require a preemptive review of a planned service before the insurance plan will agree to pay for that service.
"Prior authorization was originally intended to serve as a cost containment tool, but it has become a huge burden. Most importantly, it's affecting patients' ability to receive care," Johnson said. "The patients should be the top priority and this system is failing to do that, which is why reform of the prior authorization system is needed."
SB 3 would place limitations on how health insurance providers use prior authorization in certain circumstances when making coverage decisions. This includes:
* Prohibiting health plans from requiring prior authorization for routine services;
* Limiting the ability of health plans to change already-approved prior authorization requests;
* Speeding up decision deadlines for health plans so the system does not slow down or stop the patient's ability to receive care; and
* Requiring prior authorization decisions to be made by licensed doctors with experience and a specialty in the condition being reviewed.
These changes would limit the overuse of prior authorization by health plans and place the focus back on identifying waste, fraud and abuse.
"Senate Bill 3 would not completely do away with the prior authorization system, but reform it so patients are prioritized and given the ability to access the care that they need," Johnson said. "The current prior authorization system does not place nearly enough value on the patient. This bill would ensure that all parties involved owe a duty of care to the patient, because Hoosiers deserve to have access to health care they can trust."
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State Senator Dr.
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Original text here: https://www.indianasenaterepublicans.com/johnson-authors-patient-protection-bill



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