Public Comments for: HB481 - Prior authorization; requiring physician review for denial.
Please see attached PDF.
This bill is a good step at protecting patients. With the growth of AI, I'm concerned health insurance carriers will exponentially prioritize denials (their profit) at the expense of human lives.
Nickel and diming people’s healthcare is dangerous. It gets in the way of real people receiving the care and medicine that they need to live their lives. As a Type 1 diabetic, I don't want a company’s profit motive standing in the way of care I need, care I still have to pay for. Our legislators should pass laws that guarantee people are able to get the care that they need, when they need it, without a for-profit entity standing between them and their care. Pass these bills.
The growth of AI usage for coverage denial means that people can get denied care without a human even looking at it. Requiring a doctor's confirmation is common-sense for managing the care that people need.
Prior authorization denials are becoming a public health crisis- particularly for Medicare Advantage beneficiaries. Studies have found that nearly one in five prior authorization requests are initially denied. In many cases, the hassle of prior authorization leads patients to give up seeking treatment, leading to worsening outcomes for many patients. The stress of fighting insurers has an impact on physicians as well - many of whom suffer moral injury as a result of repeated denials of treatment they know their patients need. This problem is only getting worse now that insurers are using AI algorithms to make prior authorization decisions. This legislation is a small but important step in the right direction. Requiring that all denials be reviewed by a human physician is basic common sense, and I hope all members of this subcommittee will vote in favor of this bill.
Dear Chair Maldonado and Members of House Labor and Commerce Subcommittee #1, On behalf of the Virginia Association of Hematologists and Oncologists (VAHO) and the Association for Clinical Oncology (ASCO), I'm pleased to submit a letter in support of HB 481 (attached). Please don't hesitate to reach out if you have any questions about cancer care; we're happy to be a resource. Best, Sarah Lanford Associate Director of State Advocacy Association for Clinical Oncology (ASCO)
Good afternoon, my name is Bruce Silverman. I am from Goochland County, Virginia. I am a retired physician specializing in Nephrology. I am speaking in support of HB 481. As we discuss and debate the rules for prior authorization, let’s be clear. Prior authorization has never been demonstrated to save health care dollars or protect patients from unsafe procedures or medications despite what the insurance industry would have you believe. Actually, we now have 40 years of evidence to the contrary. In the congressionally commissioned report by MedPac, the Medicare Payment Advisory Commission, documents that Medicare Advantage plans which rely heavily on prior authorization to control cost are now costing the Federal government $84 Billion more per year than Traditional Medicare. That is 22% more per individual. Traditional Medicare rarely uses prior authorization. At least up until this year. In addition, the AMA has documented that prior authorization is the number one cause of moral injury to physicians in practice today. They site that they are spending on average 14 hours per week on prior authorization that they find demoralizing and demeaning. This is especially true when you consider our education encompasses between 11 and 15 years. Many physicians have documented that delayed or denied care due to prior authorization has caused their patients injury or death. Not having a board-certified peer to provide analysis of prior authorization continues to put our patients and physicians at risk. Are you at present willing to risk the lives of your constituents to an unproven algorithm established by profiteering insurance companies that are already under criminal investigation for their egregious practices by the Federal government and others or do you trust your physician to do the best established and safe medical practice for you and your loved ones. Thank you.