Pennsylvania lawmakers pass prior authorization reform bill

A Pennsylvania bill aiming to streamline the prior authorization process is headed to the governor's desk after state lawmakers passed the legislation Oct. 26. 

If signed into law, the bill would require insurers to provide timely approval for both nonurgent and emergency healthcare services to physicians before services and treatment plans are rendered, according to a news release from sponsor Sen. Kristin Phillips-Hill's office.

It would also create a timely process for appeals determinations, and if an insurer questions the necessity of a service, the bill calls for a peer review by a physician from the specialty in question. It would also create an electronic portal with all prior authorizations and accompanying paperwork flowing into one site. 

The bill would also create streamlined step therapy guidelines for prescription drugs and new options to obtain exemptions to best treat the medical condition of the patients, according to the release. 

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