Prior authorization (PA) is a health plan cost-control process that requires health care professionals to obtain advance approval from the health plan before a prescription medication or medical service qualifies for payment and can be delivered to the patient. To assess the ongoing impact the PA process has on patients, physicians, employers, and overall healthcare spending, the American Medical Association (AMA) annually conducts a nationwide survey of 1,000 practicing physicians. As this year’s findings demonstrate, the PA process continues to have a devastating effect on patient outcomes, physician burnout, and employee productivity. 

KMA supports HB 423, which would establish a prior authorization exemption program designed to automatically waive prior authorization requirements if a physician has been approved for a specific procedure/service (not more than) 93% of the time. This prior authorization exemption program would ensure patients have timely access to the care they need, reduce administrative burdens for physicians, and lower healthcare costs. Further, this legislation establishes robust prior authorization reporting requirements, giving the General Assembly the ability to discern whether the number of prior authorizations is increasing or decreasing. 

Contact your Senator today and ask for their support for HB 423. KMA has prepared an issue paper to assist you in communicating the impact of prior authorizations on your patients and practice.

Contact Your Senator
and ask them to SUPPORT House Bill 423.

Legislative Message Line: (800) 372-7181