The goal of prior authorization requirements is to decrease unnecessary health care spending. Often times, however, patients do not receive timely care due to lengthy steps required to obtain prior authorization. Patients could face life threatening conditions because doctors must wait until prior authorization is granted to provide necessary care. After examining grievances from doctors and consumers, state legislators are now looking for ways to speed up this process.
According to an article in Kaiser Health News, Michigan is one of the first states to implement a restructured process. On April 7, 2022, Governor Gretchen Whitmer signed the Prior Authorization Law Senate Bill 247, with the objective to reduces wait times, streamline physician and payer interactions, reduce paperwork, and improve access to care for patients. The new law institutes shorter time frames for acting on requests and notifying providers of requirement changes. In addition, insurers are expected to use regulated electronic transaction procedures for requests (Michigan State Medical Society). The result is that patients in Michigan will no longer have to wait 30 days or more to receive prior authorization for their care. The hope is that other legislators will follow Michigan’s lead to expedite the authorization process in their state. For more information on upcoming changes, visit https://www.msms.org/About-MSMS/News-Media/prior-authorization-reform-has-been-signed-into-law.