HB4055PASSSPRINGFIELD – In an effort to expand access to medication for hereditary bleeding disorders, State Senator Dave Koehler advanced a measure to cut red-tape practices used by insurance companies.

“Prior authorization processes can delay vital medical care, putting patients’ lives at risk,” said Koehler (D-Peoria). “We need to ensure Illinoisans can access the medications they need without delays.”

House Bill 4055 would prohibit prior authorization for FDA-approved medication for the treatment of hereditary bleeding disorders for up to six months. Prior authorization is a form of approval by insurance companies utilized before agreeing to cover medications and procedures. These checks can be for age, medical necessity, the availability of a medical alternative or drug interactions.

“This bill addresses the pre-authorization abuse that we see too often,” said State Representative Bill Hauter (R-Morton). “Those with bleeding disorders are oftentimes required to go to the emergency department, which delays care, is crowded or unable to handle their condition and then they have to be transferred to another ED for definitive care and factor. This can all be avoided if these patients can just simply go to their specialty physician and pharmacy. This bill removes the ED visit for pre-authorization and will help patients get the acute care they need in a timely fashion.”

According to the American Society of Hematology, mortality rates and hospitalization rates for bleeding complications from hemophilia — an inherited bleeding disorder in which the blood does not clot properly — were 40% lower among people who received care in hemophilia treatment centers than those who did not receive this care. Koehler worked closely with the Bleeding and Clotting Disorders Institute and Representative Hauter to bring this legislation to the Senate. By eliminating prior authorization, Koehler’s bill aims to streamline the processes for patients to receive necessary treatment.

“Many patients do not have time to jump through unnecessary hurdles,” said Koehler. “This measure puts patients first, protecting those whose lives are at stake.”

House Bill 4055 passed the Senate Wednesday.