Pennsylvania lawmakers target use of prior authorizations

Pennsylvania lawmakers have introduced legislation that would require insurance companies to use a standardized prior authorization approach, according to The Morning Call.

The bills — introduced in the state House and Senate by Rep. Steven Mentzer of Lancaster County and Rep. Kristin Phillips-Hill of York County — aim to standardize insurers’ prior authorization approach by requiring insurers to do them electronically and pay for the procedure if it is authorized, the newspaper reported.

Insurance companies use prior authorizations to determine whether they will cover costs of treatments and procedures prescribed by physicians.

In Pennsylvania, insurers may require prior authorizations for some care, and may deny use of a treatment during that process, according to The Morning Call.

But sponsors of bills in the state legislature are hoping to curb what they deem “excessive and unreasonable” use of prior authorizations by insurance companies.

The legislation is supported by the Pennsylvania Orthopaedic Society. A representative with the Insurance Federation of Pennsylvania told the newspaper he hadn’t seen the proposed legislation but has opposed previous draft versions.

https://www.beckershospitalreview.com/finance/pennsylvania-lawmakers-target-excessive-and-unreasonable-use-of-prior-authorizations.html