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Illinois Lawmakers Take Aim At 'Prior Authorization' In Health Insurance

Isabella McKenna (center) speaks at a press conference alongside (from left to right) Sen. Linda Homes, Rep. Greg Harris and Illinois State Medical Society President Paul Pedersen.
Mike Smith | NPR Illinois

Illinois lawmakers want to reduce delays in medical care caused by the requirements of insurance companies.

They said the process, known as “prior authorization,” is time-consuming and raises unnecessary obstacles for people in need.

Isabella McKenna has been dealing with arthritis since she was age 14. She said several times in her life, she had to wait for prior authorization to get medical care, often leaving her impaired.

“I needed a medication that could help me walk unaided and live with less pain,” she said. “I was walking with a cane and could barely hold a pencil, yet it took months for prior authorization.”

McKenna said prior authorization has only made her condition harder to deal with.

“My father had to make countless phone calls,” Mckenna said. “My doctor had to take the time to give them reason after reason why I needed this test, and in the end, they, the insurance company, not my doctor, decided it was unnecessary.”

Supporters of the legislation include the Illinois State Medical Society and other physician groups. They said reducing prior authorization would save money and allow medical providers to focus on people rather than paperwork.

Insurance-industry representatives did not immediately respond to a request for comment.

The legislation is Senate Bill 3822 and House Bill 5510.

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