Governor Bevin signs law on March 26, 2019
Imagine you’re diagnosed with a chronic condition like rheumatoid arthritis, which rocks your world and changes life as you have known it. With the help of a good physician, you develop a treatment plan that will hopefully improve your condition and make the tasks of daily life manageable.
However, your shock comes when you learn it may take weeks to get approval by your insurance company for your treatment plan to go into effect. The chance looms that you may not get covered. Permanent joint damage can occur while you’re waiting. Patients ask: Who is determining my health care needs? If you have experienced prior authorization, you know how frustrating it can be.
Angela Young experienced the delay of prior authorization firsthand.
“My physician decided the biologic medication I was on was not working. It took over six weeks before a new biologic was approved. Since we had already stopped the first biologic, I was not on any medication for a long period. The pain level required I return to prednisone, which causes other issues, such as weight gain, thinning of bones, interrupted sleep and higher blood glucose levels. I ended up needing a painful procedure to reduce the buildup of fluid in my knee. I can’t help but think if I had gotten the new medication approved sooner, I would have been able to avoid this painful procedure.”
The exciting news is that — with the passage of SB 54, legislation sponsored by Sen. (and physician) Ralph Alvarado — the delays in care should become the exception, not the rule, as barriers are removed.
自2020年1月1日起，紧急护理24小时内，非紧急服务5天内，患者和提供者将收到事先授权的回复。不应该再像过去那样，拖延需要数周才能解决。对于维持型药物，即使在承保期内药量发生变化，每年也只需要一次事先授权即可。最终，患者将能够更有效地实施医生开出的治疗方案。
关节炎基金会肯塔基州的倡导主席谢丽尔·苏尔总结道:“从长远来看，这项法案将降低每个人的成本，并将疼痛和对身体的永久伤害降至最低。减少病人等待适当药物的时间也将减少不必要的程序的费用，这些费用必须由保险机构承担。”
You’ve experienced the excitement of advocacy success. Don’t stop here!
请帮助我们在联邦一级提高对逐步治疗改革重要性的认识。再过五分钟，请你们的国会议员支持安全步骤法案。