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Kentucky Medical Association calls for passage of bill to reform prior authorization process

Physicians from across the Commonwealth gathered Wednesday in Frankfort to call for the passage of House Bill 134, sponsored by Rep. Kim Moser of NKY.

The legislation reforms the prior authorization process to improve access to care, reduce administrative burdens for medical providers and lower healthcare costs. House Bill 134 is moving through the General Assembly and will be heard in the House Health Services Committee on Thursday, February 23.

More than 90 Kentucky physicians were in attendance and spent the day meeting with legislators and sharing their personal stories of how their patients and practices have been negatively impacted by unnecessary prior authorization requirements. Rep. Moser and Monalisa Tailor, M.D., president of the Kentucky Medical Association, spoke at a press conference held in the Capitol Rotunda.

“Kentuckians shouldn’t have to worry if they’ll be able to access the treatments and medications prescribed by their doctor. Unfortunately, that’s the case for many Kentucky patients because of the lengthy prior authorization process,” said Rep. Moser. “I’m proud to sponsor House Bill 134 to make it easier for patients to get the treatments they need without delay and give back valuable time to physicians.”

“As physicians, we chose a career in medicine because we care deeply about serving and helping others,” said Dr. Tailor. “We want to spend more time engaging with patients and less time talking on the phone with insurance companies, completing cumbersome prior authorization paperwork and pleading for our patients to get the treatment we know they need.”

Prior authorization reform has been a long-time priority for the Kentucky Medical Association. Earlier this month, the group launched a new campaign to educate Kentuckians on the issue and encourage policy solutions: ReformPriorAuth.org.

House Bill 134 creates a prior authorization exemption program that automatically waives prior authorization requirements if a provider has historically been approved for a specific procedure or service at least 90 percent of the time.

In a recent KMA member survey, 7 in ten physicians indicated the amount of work associated with the prior auth process has increased in recent years. More than 80 percent said that issues related to the prior auth process led to delays or changes to their patients’ recommended course of treatment.

Furthermore, according to a 2021 American Medical Association survey, 34 percent of physicians report prior authorization has led to a serious adverse event for a patient in their care, including hospitalization, a life-threatening event or required intervention to prevent permanent impairment or damage, and even more unfortunately, a patient’s disability/permanent bodily damage, congenital anomaly/birth defect and even death.

“No patient I’ve known, and no physician or caregiver I’ve met, has ever said that we need more prior authorizations to make healthcare better—because we all know they do just the opposite,” added Dr. Tailor. “House Bill 134 proposes meaningful changes to the prior authorization process that will positively impact Kentuckians who are trying to manage their health and the providers who serve them.”

House Bill 134 has broad support from patient and provider organizations, more than 20 of which have signed a letter to legislators urging them to vote in support of the bill.


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