WASHINGTON (TNND) — Health insurance reform, including more timely access for patients, will roll out early next year, said Medicaid Services Administrator Dr. Mehmet Oz.
Oz announced these reforms, along with Secretary of Health and Human Services Robert F. Kennedy Jr., at a news conference in Washington, D.C..
The changes, which are voluntary, focus on prior authorization, which means insurers require approval before covering medical care, a prescription or services like an imaging exam. Insurers say they do this to guard against care overuse and to make sure patients get the right treatment.
“It frustrates doctors, it sometimes that results in care that is significantly delayed, it erodes public trust in the healthcare system” said Oz at a news conference in Washington, D.C.
Grey’s Anatomy actor Eric Dane said prior authorization impacts chronic illnesses, such as ALS.
“The worst thing that we can do is add even more uncertainty for patients and their loved ones with unnecessary prior authorization,” Dane said.
Sen. Roger Marshall, R-Kans., said he is also working on legislation about prior authorization.
“I think we owe it to our patients to go ahead and codify something,” Marshall said.
On Monday, UnitedHealthcare, CVS Health’s Aetna and dozens of other insurers announced they plan to reduce the scope of health care claims subject to prior authorization, standardize parts of the process and expand responses done in real time.
“I want to applaud the insurance companies for taking that very brave first step,” Oz said.
Insurers also announced that they will standardize electronic prior authorization by the end of next year, as well as reduce the scope of claims subject to medical prior authorization. They also plan to expand the number of real-time responses and ensure medical reviews are done for denied requests.
They will also honor the preapprovals of a previous insurer for a window of time after someone switches plans.
Oz called the practice “a pox on the system” that hikes administrative costs during his Senate confirmation hearing in March.
The Associated Press contributed to this report.
