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SB 247, Prior Authorization Legislation
Senator Curt VanderWall introduced SB 247, legislation that would reform the prior authorization process for both medical and pharmaceutical benefits. The legislation sets forth transparency measures and reporting requirements; timelines for decision-making around a prior authorization request; setting parameters around insurance use of clinical review criteria, including the use of peer-reviewed criteria, among other things. It would also include a process whereby insurers could set up a “gold-card” or expedited consideration for certain procedures or treatments.
The Arc is a member of the Health Can’t Wait coalition, which has been leading efforts to reform the prior authorization process. While in the eyes of coalition members the legislation still needs improvement, it is a good step forward to meeting reform goals. The Senate voted out the legislation on Thursday, April 29 by a vote of 35-0. The Arc supports.
Advanced Practice Professionals Mental Health Legislation
Senate Bill 191 would expand the definition of mental health professionals under the Mental Health Code to include physician’s assistants, certified nurse practitioners, and certified clinical nurse specialists. The bill would allow an advanced practice professional to conduct a physical examination as part of the certification process for involuntary treatment as well as submitting a clinical certification for voluntary treatment in a hospital. The legislation also permits an advanced practice professional to order or authorize restraints and seclusion. In general, the bill confers broader authority to these health care professionals in the mental health space, which has raised concerns from groups, like the Arc.
The Senate voted out the legislation on Thursday, April 29 by a vote of 35-0. The Arc opposes.