The Financial Institutions and Insurance Interim Study Committee met on October 3 to discuss prior authorization. The debate at hand was whether a health insurer or HMO should be required to exempt a participating health care provider from needing to receive prior authorization on a particular health care service if the provider has continuously received approval for the health care service for a determined number of months.
The provider community expressed their concerns of prior authorization and the burdens it places on them, the interruption of the continuity of patient care, the frequent documentation and the possible negative impacts on patient care. The business community reminded the committee that any legislation would only affect a small amount of the market and self-insured plans would not be impacted by any legislation.
The Indiana Chamber testified that we are still operating under a managed care system and that until we move to a value-based, quality care system, prior authorization is a tool to control costs. Much of what was brought before the committee has been discussed on numerous occasions during past legislative sessions.
The committee did not make a recommendation regarding prior authorizations to the Indiana General Assembly at this time.
Resource: Mike Ripley at (317) 264-6883 or email: mripley@indianachamber.com
