Daily News | Chronically ill patients could get easier access to new treatments if Pa. lawmakers act soon
HARRISBURG — Chronically ill patients could find it easier to get their insurance companies to OK new treatments under a bill Pennsylvania lawmakers are hustling to pass in the final days of the legislative session.
Industry groups for insurers, hospitals, and doctors all have a strong lobbying presence in the Capitol. The Insurance Federation of Pennsylvania in particular spends millions of dollars every year to influence legislators. At the core of the proposal is an effort to change two key components of the American health care system — prior authorization and step therapy.
It would do so by creating standardized electronic forms to apply for approval, setting a statutory timeline for responding to requests , requiring written notice from insurers explaining the denial, and giving the state Insurance Department the ability to review the decision. Private insurers defend their review powers as a necessary cost control method to keep insurance rates down. But advocates for patients and providers argue these administrative steps favor insurance companies and diminish their ability to make important health care decisions.