As a physician, you want to provide the best care for your patient. We know that every day insurance companies make you jump through unnecessary hoops before you can deliver the care your patient needs. From prior authorization to step therapy to pre-certification, care for your patients is delayed or denied because of bureaucracy.

Prior authorization started in 1980s as a way to control costs of prescription drugs. Now, insurers require prior authorization for surgery, imaging, and medication. Not only is prior authorization burdensome, it can have negative consequences on patient care and has failed to provide cost savings.

Prior authorization impacts a physician’s ability to delivery appropriate care in a timely manner.

2019 General Assembly Update

MSV supports SB 1607 (Dunnavant), a bill that would reform and streamline prior authorization for medications. The bill would also ensure payment for pre-approved surgeries and invasive procedures; during an approved procedure, if a physician provided appropriate additional medical care they would be reimbursed without requiring an additional authorization. SB 1607 passed the Senate and the House Commerce and Labor Committee. It now moves to the House floor for consideration.

MSV also supports HB 2126 (Davis) is a step therapy reform bill that would create medically necessary exemptions to step therapy protocols and create an expedient exemption process for patients already on an effective treatment. HB 2126 passed the House; it now moves to the Senate Commerce and Labor Committee for consideration.

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Resources

Prior Authorization Infographic | Version for Printing

Prior Authorization - Leave Behind

Step Therapy - Leave Behind