holmes 050521SPRINGFIELD – Prior authorization is a health insurance company practice meant to ensure treatments are medically necessary, but it often forces patients to wait too long for treatments they need. House Bill 711, sponsored by State Senator Linda Holmes (D-Aurora) to rein in that practice, passed the Senate Insurance Committee on Wednesday.

“People requiring surgery, supplies or services often experience stressful delays as they await approval for medical treatment, and it is past time to shorten and simplify that process,” Holmes said. “For those with chronic or life-threatening conditions, it can be an ongoing battle for however long the treatment continues.”

The Prior Authorization Reform Act would create a system that requires transparency, appropriate peer-to-peer review, medically appropriate timelines for both urgent and non-urgent care, and continuity of care. If authorization is approved for a given treatment, related supplies or services would also be considered to be authorized, and the approval would remain in effect for the extent of the care.

“This measure also sets maximum wait times for prior authorization requests, confirms payment for the delivery of the health care service, and reduces the number of services that are subject to prior authorization requirements,” Holmes said. “To be clear, we are not trying to eliminate prior authorization, but to reform it for a smoother, less stressful experience for patients.”

HB 711 passed the House unanimously on April 21, and following its passage out of the Senate Insurance Committee with bipartisan support, it now goes to the full Senate for consideration.

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