holmes 052721 2SPRINGFIELD – Health insurance companies use prior authorization on patients’ proposed treatments, meant to ensure they are medically necessary. However it often forces patients to wait too long for needed and appropriate treatments. House Bill 711, sponsored by Senator Linda Holmes (D-Aurora) to ensure more timely approval, passed the Senate Friday.

“It can be stressful for people requiring medical treatment such as surgery, or supplies and services to wait on approval for medical treatment, and these delays must end,” 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 ensuring continuity of care. If authorization is approved for a given treatment, related supplies or services would also be considered to be authorized, and would remain in effect for the extent of the care.

“Maximum timelines for urgent and non-urgent prior authorization requests must be set, and a prior authorization determination will confirm medical necessity 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.

House Majority Leader Greg Harris (D-Chicago), passed HB 711 in the House in April.

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