Action Center

Prior Authorization
Action Alert
March 27, 2019

Yesterday Gov. Matt Bevin officially signed Senate Bill 54, addressing a number of prior authorization issues, into law. The bill, sponsored by Sen. Ralph Alvarado, was a KMA priority this session and is a win for Kentucky patients and physicians.

KMA would like to thank the physician members who advocated on behalf of this bill, including KMA President Bruce Scott, M.D., who traveled to Frankfort several times to testify in favor of the legislation. It is because of the support of the KMA community that this important bill was able to secure passage.


March 19, 2019

KMA priority Senate Bill 54, sponsored by Sen. Ralph Alvarado, reported favorably from both chambers and is currently awaiting signature by Gov. Bevin. The bill addresses a number of prior authorization issues, including enhancing access to prior authorization information, establishing one-year approvals for chronic disease medications, enhancing the review process, standardizing review times, increasing access to electronic prior authorizations and requiring insurers to post prior authorization procedures on their website and maintain a complete list of services for which prior authorization is required. It will also remove several roadblocks for patients trying to access medications and treatment and allow providers to make decisions regarding care instead of insurance companies.

KMA President Bruce Scott, M.D. traveled to Frankfort several times to testify in favor of this legislation, and numerous calls were made to legislators by KMA physicians in order to see this one across the finish line.

March 12, 2019

KMA priority Senate Bill 54, sponsored by Sen. Ralph Alvarado passed the House this afternoon by a vote of 97-1. The bill addresses a number of prior authorization issues, including enhancing access to prior authorization information, establishing one-year approvals for chronic disease medications, enhancing the review process, standardizing review times, increasing access to electronic prior authorizations and requiring insurers to post prior authorization procedures on their website and maintain a complete list of services for which prior authorization is required. It will also remove several roadblocks for patients trying to access medications and treatment and allow providers to make decisions regarding care instead of insurance companies.

The bill now moves to the Senate for concurrence and then to the Governor for final signature.


March 5, 2019

Senate Bill 54, a KMA priority, unanimously passed the House Banking and Insurance Committee on Thursday. The bill now awaits consideration by the full House. SB54, sponsored by Sen. Ralph Alvarado, would enhance access to prior authorization information, establish one-year approvals for chronic disease medications, enhance the review process, standardize review times, increase access to electronic prior authorizations and require insurers to post prior authorization procedures on their website and maintain a complete list of services for which prior authorization is required.  It would also remove several roadblocks for patients trying to access medications and treatment and allow providers to make decisions regarding care instead of insurance companies.

Please contact your representative and ask them to support Senate Bill 54.

PLEASE CONTACT YOUR REPRESENTATIVE
AND ASK THEM TO
SUPPORT SENATE BILL 54.

Legislative Message Line: (800) 372-7181


February 27, 2019

Senate Bill 54 passed unanimously from the House Banking & Insurance Committee this morning.  The bill was bolstered by compelling testimony from KMA President Bruce Scott, M.D.  The KMA priority bill, sponsored by Sen. Ralph Alvarado, would enhance access to prior authorization information, establish one-year approvals for chronic disease medications, prevent retroactive denial, enhance the review process, standardize review times, increase access to electronic prior authorizations and require insurers to post prior authorization procedures on their website and maintain a complete list of services for which prior authorization is required.  It would also remove several roadblocks for patients trying to access medications and treatment and allow providers to make decisions regarding care instead of insurance companies.

KMA thanks members of the House Banking and Insurance Committee for their swift passage of this bill, but it now moves on to the full House and needs support.

Please contact your Representative as soon as possible and urge their support for Senate Bill 54!
 
PLEASE CONTACT YOUR REPRESENTATIVE
AND ASK THEM TO
SUPPORT SENATE BILL 54.

Legislative Message Line: (800) 372-7181

February 26, 2019

Senate Bill 54 passed the full Senate on Thursday by a vote of 33-1. The bill, sponsored by Sen. Ralph Alvarado, would enhance access to prior authorization information, establish one-year approvals for chronic disease medications, prevent retroactive denial, enhance the review process, standardize review times, increase access to electronic prior authorizations and require insurers to post prior authorization procedures on their website and maintain a complete list of services for which prior authorization is required. It would also remove several roadblocks for patients trying to access medications and treatment and allow providers to make decisions regarding care instead of insurance companies. SB54 now moves to the House.

Please contact your Representative and ask that they move swiftly on passing Senate Bill 54.

 
PLEASE CONTACT YOUR REPRESENTATIVE
AND ASK THEM TO
SUPPORT SENATE BILL 54.

Legislative Message Line: (800) 372-7181

February 19, 2019

Senate Bill 54, sponsored by Sen. Ralph Alvarado and a KMA priority bill, would enhance access to prior authorization information, establish one-year approvals for chronic disease medications, prevent retroactive denial, enhance the review process, standardize review times and increase access to electronic prior authorizations. This bill would remove several roadblocks for patients trying to access medications and treatment and allow providers to make decisions regarding care instead of insurance companies.

KMA President Bruce Scott, MD testified in favor of the bill in front of Tuesday’s Senate Banking and Insurance Committee. It passed favorably from the Committee.

PLEASE CONTACT YOUR SENATOR
AND ASK THEM TO
SUPPORT SENATE BILL 54.


Legislative Message Line: (800) 372-7181


February 15, 2019

Senate Bill 54, sponsored by Sen. Ralph Alvarado, would enhance access to prior authorization information, establish one-year approvals for chronic disease medications, prevent retroactive denial, enhance the review process, standardize review times and increase access to electronic prior authorizations. This bill would remove several roadblocks for patients trying to access medications and treatment and allow providers to make decisions regarding care instead of insurance companies.

SB54 is scheduled to be heard TUESDAY by the Senate Banking and Insurance Committee. Please contact your Senator as soon as possible to urge them to CALL FOR A VOTE on SB54 and to SUPPORT timely access to care for patients.

Legislative Message Line: (800) 372-7181


January 15, 2019

The current prior authorization process being utilized by payers creates roadblocks for patients trying to access medications and treatment recommended by their trusted physicians, increases health care costs, and restricts health care providers from doing their jobs effectively. Therefore, KMA supports legislation that will remove these roadblocks by enhancing access to prior authorization information, establishing one-year approvals for chronic disease medications, preventing retroactive denial, improving the review process, standardizing review times, increasing access to electronic prior authorizations, and eliminating prior authorization for medication-assisted therapy services.

Current Legislation Filed: Senate Bill 54, sponsored by Sen. Alvarado, would enhance access to prior authorization information and remove several barriers for patients trying to access medications and treatment and allow providers to make decisions regarding care instead of insurance companies. SB54 has been assigned to the Senate Banking and Insurance Committee. House Bill 121, sponsored by Rep. Kim Moser, would prohibit insurers from setting requirements or using certain utilization reviews for certain prescription drugs used to treat opioid use disorder and amend KRS 205.536 to prohibit the Department for Medicaid Services or a Medicaid managed care organization from setting requirements or using certain utilization reviews for certain prescription drugs used to treat opioid use disorder. HB121 has been assigned to the House Health and Family Services Committee.

January 1, 2019

Over the past year, KMA has engaged members through its AIM for Better Care Initiative to identify and work toward solutions, either through legislation, regulation, or public awareness, to lessen administrative burdens.  Through this effort, prior authorization has consistently been pinpointed as a nonclinical activity for which physicians and practice staff spend an enormous amount of time, energy, and resources.  The current prior authorization process being utilized by payers creates roadblocks for patients trying to access medications and treatment, increases health care costs, and restricts health care providers from doing their jobs effectively.  Therefore, KMA supports legislation that will remove these roadblocks by enhancing access to prior authorization information, establishing one-year approvals for chronic disease medications, preventing retroactive denial, improving the review process, standardizing review times, increasing access to electronic prior authorizations, and eliminating prior authorization for medication-assisted therapy services.
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