State Rep. Donna Schaibley’s (R-Carmel) proposal streamlining the prior authorization process when requesting to receive medical care is heading to the governor for consideration as a new law.
Schaibley
As part of insurance billing processes, health coverage plans may require a prior authorization request from physicians indicating treatment is medically necessary. Insurance plans may not cover an individual’s treatment without prior authorization.
Schaibley’s legislation establishes clear guidelines for health insurance plans requiring prior authorization for procedures or treatments, and facilitates that process between providers and insurers.
“There is no standard prior authorization process among the various insurance providers, and as a result, patients may face delays in receiving important medical care,” Schaibley said. “These guidelines will streamline the prior authorization process, protect patients and give an idea of when they will hear back regarding requests.”
Schaibley said the proposal also requires submitting these requests electronically, which is more secure than by mail and can help prevent fraud.
For more information on House Enrolled Act 1143, visit iga.in.gov.