Last week the Senate took steps to reduce obstacles patients face when they need to get approval from their insurance carrier before receiving a treatment ordered by their doctor.
“All of us at some point in our lives are patients,” Sen. Jeff Gordon, R-Woodstock, said.
Gordon, who is also a physician, said the process by which treatments are approved has eroded over the years and the legislation that is headed to the House would remove some of the barriers.
For non-urgent care it would reduce the wait time from 15 days down to 7 days and for urgent care would be reduced from 48 hours down to 24 hours. It will also require the insurance carriers to institute an electronic form of approval because it varies at the moment and some are still using fax machines.
“Delays in patient care can have serious ramifications, I’d like to say that’s rare but it does happen a lot,” Gordon said.
He said he had a 50 year old patient with lung cancer and recommended an FDA approved treatment, but because of delays and a request from the insurance carrier to use a treatment that he knew wouldn’t work, his patient ended up in the hospital where he finally received the treatment Gordon initially recommended.
Gordon said that hospital care is more expensive and that could have been avoided if the insurance carrier had approved the treatment when he recommended it.
“This is about providing good care for the people of Connecticut,” Gordon added.
Sen. Saud Anwar, D-South Windsor, who is also a physician, said patients can’t wait for these authorizations.
“Diseases don’t go through the bureaucratic processes,” he said.
Dr. David Hass, a gastroenterologist who is president of the Connecticut State Medical Society, said initially prior authorization was a way to prevent overutilization of care, but it’s become a huge administrative burden for every physician.
“And over 90% of things initially denied are eventually approved,” he added. “Because most of the time physicians who are prescribing medications or ordering tests or scans, they’re doing it for the right reasons, of course, and they’re doing it in the interest of patient care.”
He said this will give doctors more time to see their patients and reduce the cost of health care from emergency room visits, which are more expensive.
The bill passed the Senate 35 to 1, only Sen. Rob Sampson, R-Wolcott, voted against it.
The bill which also changes how drugs are approved for some patients and wouldn’t require those who are receiving treatment for autoimmune disorders, multiple sclerosis, or cancer to fail a drug they’ve already failed.
Senate President Martin Looney, D-New Haven, said the bill was a priority for the Senate.
However, Hass, said they have a lot of work to do to make sure the bill is called in the House.
“And make sure they understand this would be a win for patients in Connecticut,” Hass added.