prior auth 081921SPRINGFIELD – Health insurance companies use prior authorization on patients’ proposed treatments, meant to ensure they are medically necessary. However it often forces patients to wait too long for needed and appropriate treatments. House Bill 711, sponsored by Senator Linda Holmes (D-Aurora) to ensure more timely approval, was signed into law by the governor on Thursday.

“It can be stressful for people requiring medical treatment, supplies and services to wait on approval for medical treatment, and these delays must end,” Holmes said. “For those with chronic or life-threatening conditions, it can be an ongoing battle for however long the treatment continues.”

The Prior Authorization Reform Act would create a system that requires transparency, appropriate peer-to-peer review, medically appropriate timelines for both urgent and non-urgent care, and ensures continuity of care. If authorization is approved for a given treatment, related supplies or services would also be considered to be authorized, and would remain in effect for the extent of the care.

“Maximum timelines for urgent and non-urgent prior authorization requests must be set, and a prior authorization determination will confirm medical necessity requirements,” Holmes said. “To be clear, we are not trying to eliminate prior authorization, but to reform it for a smoother, less stressful experience for patients. I appreciate House Majority Leader Greg Harris’ (D-Chicago) sponsorship of this in the House.”

House Bill 711 will take effect Jan. 1, 2022.