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Keep Up-to-Date on Prior Authorization Reform Legislation, SB 247: Health Can’t Wait
Senate Bill 247 introduces new transparency and clinical validity requirements that would protect Michigan patients from costly and dangerous delays in access to health care. The legislation is the reintroduction of prior authorization reform, which previously took the form of SB 612 during the last legislative session. The Health Can’t Wait Act would establish:
• Transparency – Insurance company prior authorization requirements will be published on the insurer’s website in detail and in easily understandable language, and that aggregated information about prior authorization approval and denials are made publicly available.
• Clinical validity – Clinical review criteria is based on current peer-reviewed evidence and individuals with a financial stake in the outcome of prior authorization decisions are prohibited from the decision-making process.
• Fairness for patients – Urgent and non-urgent prior authorization requests must be acted upon in a timely manner and clinicians and patients are properly notified of new or amended prior authorization requirements.
The Michigan Senate unanimously passed SB 247 this spring. The House is expected to introduce companion language soon. Consider submitting a personal prior authorization story on the Health Can’t Wait website https://www.healthcantwait.org/.
Protect Michigan’s Patients
by Opposing HB 4355: Telemedicine Licensing and Oversight Requirements
This spring, the Michigan House of Representatives narrowly passed House Bill 4355, legislation that would allow out-of-state doctors to treat Michigan patients via telemedicine without a Michigan license or oversight requirements. If this bill becomes law in its current form, large companies could force many practices out of business, ultimately reducing the quality of care for patients and placing Michigan’s health care market at a competitive disadvantage. The bill is now under consideration by the Senate Health Policy & Human Services Committee, and while organized medicine is seeking amendments to narrow the scope of the bill to limited situations, we remain opposed to HB 4355 as it is currently written. Go to https://cqrcengage.com/ msms/app/onestep-write-a-letter?9&engage- mentId=511569 to take action now! •
Volume 73 • Number 2 Washtenaw County Medical Society BULLETIN 13