Pennsylvania legislators push for streamlined prior authorization process

Pennsylvania lawmakers are considering a bill that supporters say will streamline the prior authorization process, CBS affiliate WHP reported Oct. 24. 

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If approved, the legislation would set standards for commercial insurance and Medicaid plans when seeking prior authorization approvals, according to a news release from sponsor Sen. Kristin Phillips-Hill’s office. The bill would require insurers to provide timely approval for nonurgent and emergency healthcare services to providers. It would also create a timely process for appeals determinations.   

In addition, the bill would create an electronic portal with all prior authorizations and accompanying paperwork flowing into one site, WHP reported. 

If an insurer questions the necessity of a service, the bill calls for a peer review by a physician from the specialty in question, according to the report. 

The state Senate approved the bill in June and is now in the House for further consideration.  

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