Patients are nearer each day getting closer to meaningful prior authorization and step therapy reforms thanks to the work of diligent patient advocates in the state legislature, led by Senator Curtis VanderWall.
Senator VanderWall is both the Chairman of the Senate Health Policy and Human Services Committee and the sponsor of Senate Bill 612, a reform that would shorten patients’ wait for the treatment, medicine, and testing ordered by their health care providers.
“The term “prior authorization” refers to the process insurance companies use to determine whether an enrollee is eligible to have certain health care services, procedures, or prescription drugs covered by insurance,” said Senator VanderWall. “Unfortunately, the prior authorization process has created barriers and inefficiencies regarding access and quality of care in the health care system. Several of my own constituents have told me accounts of how this process has endangered their health.”
VanderWall represents a wide swath of northern lower Michigan, including Benzie, Crawford, Kalkaska, Lake, Leelanau, Manistee, Mason, Missaukee, Ogemaw, Osceola, Roscommon and Wexford counties. Before coming to Lansing, he made his living as the owner of Turf Care Mole Man of Ludington, and worked much of his life at Eberhard Foods and Prevo’s Family Market. He understands the importance of meeting the needs of everyday Michiganders – he made a career out of it.
When patients reached out to his office to share difficult experiences they’d had obtaining the prescriptions and the medical treatment they needed because of onerous insurance company practices, VanderWall got to work on a solution. The result is Senate Bill 612, a reform that’s already gained bipartisan co-sponsorship, and numerous hearings in Lansing.
“Senate Bill 612 would reform the prior authorization process to facilitate transparency, improve access to care and eliminate some of the burdens that exist,” said VanderWall. “For patients, this bill would improve their ability to receive prompt access to necessary care by reducing the review timeframes permitted for insurance companies to make determinations for standard and urgent prior authorization requests.
“My measure also would allow physicians the ability to waive step therapy protocols when it is found to be in the best interest of the individual patient.”
Thanks to his leadership, patients, physicians, health care providers, and patient advocacy organizations have had the repeated opportunity to speak directly to lawmakers, to share their stories, and to fight for prior authorization and step therapy reforms.
VanderWall encourages everyone affected by prior authorization and step therapy delays to contact their state Senators and Representatives asking them to support SB 612. They and others can thank Senator VanderWall for his leadership in this fight, too, by visiting his website, http://senatorcurtvanderwall.com/contact.