Senate approves VanderWall bill to improve patient care

LANSING, Mich. — The Michigan Senate on Thursday unanimously passed a bill sponsored by Sen. Curt VanderWall to improve the administration of effective, patient-centered care in the state.

Senate Bill 247 would improve the prior authorization process health insurance companies use to determine if an insured person is eligible to have certain health care services, procedures or prescription drugs covered.

“My measure will reform the prior authorization process, which has created barriers and inefficiencies with access and quality of care in the health care system,” said VanderWall, R-Ludington. “It will promote transparency of utilization management practices used by insurers, which will allow enrollees and health care providers to be fully informed while making coverage and care decisions.”

SB 247 would require that beginning Jan. 1, 2023, insurers and health care providers and professionals must perform the prior authorization process solely through the use of a standard electronic transaction.

The legislation also would ensure that insurance companies are creating prior authorization requirements based on relevant and up-to-date evidence-based clinical guidelines — and not solely on cost containment — and would improve an enrollee’s ability to receive prompt access to necessary care by reducing the review timeframes permitted for insurance companies to make determinations for standard (non-urgent) and urgent prior authorization requests.

“While the intent behind the prior authorization process is to promote safe, timely, and cost-effective care, the process itself has been widely viewed as inefficient and burdensome,” VanderWall said. “This can directly affect the treatment and care a patient receives and could pose significant risks to a patient’s health. This bill will help improve the process.”

SB 247 now heads to the Michigan House of Representatives.