Advocates push lawmakers to ensure doctors, not health insurers, decide medical treatments

Health

HARRISBURG, Pa. (WHTM) — Patient advocates and health care workers are hosting an event to push lawmakers to take action. They want them to move forward with legislation that would take some power from health insurers and give it back to doctors.

House and Senate Bills 225 would let doctors prescribe medicines without being stalled or stopped by insurance companies.

They would put an end to restrictive prior authorization and step therapy, also known as fail first practices, required by some health insurers.

Prior authorization makes prescribers get approval from insurers before giving medicine or moving forward with specific treatments.

Patient advocates say it started as a method to control costs for experimental or new procedures, but now it’s having debilitating effects for people with serious diseases, and forcing some to wait for what could be life-saving relief.

Step therapy requires patients to try, and fail, one or more medications, tests or treatments chosen by their insurance company before getting what was actually recommended by their doctor.

The American Medical Association says 78% of patients report prior authorization delays lead them to abandonding their treatment, and 92% of doctors report prior authorization delays can have a negative clinical impact on patients.

“This legislation and this process by which to put the control, the decision-making back into the physicians hands is really critical because you just can’t template out patient care,” said Dr. F. Wilson Jackson, the vice president of the Pennsylvania Medical Society. “It just doesn’t work, despite our best efforts, and physicians are on board with trying to reduce the costs when we can reduce the costs, but the physicians also really know how to best treat the patient.”

The event on the front Capitol steps starts at 11 a.m.

Several patients and providers are set to share their personal experiences and stories.

Copyright 2021 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Trending Stories

Don't Miss