Michigan Gov. Gretchen Whitmer signed legislation April 7 that reforms the prior authorization process in Michigan.
The Health Can't Wait Act shortens the time payers have to consider prior authorization requests before they are considered granted and requires payers to provide more information to the public and providers regarding the prior authorization process, according to an April 7 news r release from Michigan's Legislature.
Four provisions of the new law:
- Prior authorization requirements from payers must be published on the payer's website in detail and in easily understandable language. Aggregated information about prior authorization approval and denials must also be made publicly available.
- Payers must base their prior authorization requirements on clinical, evidence-based criteria established with input from practicing physicians.
- Clinical review criteria is based on current peer-reviewed evidence. Individuals with a financial stake in the outcome of prior authorization decisions are banned from the decision-making process.
- All prior authorization requests must be acted upon in a timely manner. Clinicians and patients must be properly notified of new or amended prior authorization requirements.