Health advocates want to limit prior authorization by insurance companies

Isabella McKenna has dealt with severe arthritis for much of her life. (PHOTO: Dave Dahl)


By Dave Dahl

SPRINGFIELD– Doctors and patients say they’ve had it with some paper-pusher at an insurance company standing between you and your treatment.

The Illinois State Medical Society brought Isabella McKenna to a Capitol news conference. She has dealt with severe arthritis for much of her life.

I had spent weeks unable to walk, weeks in horrible pain, yet unable to receive treatment, all because I could not get prior authorization from my insurance company in a reasonable time frame,” McKenna told reporters. “My father had to make countless phone calls, my doctor had to take the time to give them reason after reason why I needed this test.

“In the end, they — the insurance company, not my doctor — decided it was unnecessary.”

“As somebody who has been diagnosed with MS for over thirty years now,” said sponsoring State Sen. Linda Holmes (D-Aurora), “I understand the need for getting the authorized medical care that your physician — not someone who is reviewing documents (and) who doesn’t have this medical knowledge — has prescribed and said you need to maintain your best possible health.”

The bill, among other things, requires disclosure (such as on the insurer’s web site) about authorization policies; outlaws repeated requests for authorization of the same prescription drug; and requires comprehensive reviews — for example, approving both the anesthesia and the surgery.


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