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DENVER, CO – The House today passed legislation to streamline access to health care. HB24-1149, sponsored by Representative Shannon Bird, would modify requirements for prior authorization of certain procedures and prescription drugs so Coloradans can receive the care they need.
“Insurance companies’ prior authorization requirements often delay care and cause health conditions to worsen or completely discourage Coloradans from seeking the health care they need,” said Rep. Shannon Bird, D-Westminster. “Our bipartisan bill eases some of the current prior authorization requirements and keeps healthcare decisions between patients and providers. We’re also focused on improving health insurer transparency so patients will know what procedures, medications and prescriptions are covered.”
HB24-1149, also sponsored by Representative Lisa Frizell, R-Castle Rock, passed by a vote of 55-6. It would improve Colorado’s prior authorization requirements to streamline health care services, and procedures, and increase access to prescription drugs for patients. Due to health care insurer requirements surrounding prior authorization, 94-percent of physicians report care delays because of prior authorizations. This also leads to an overall increase in treatment abandonment by patients. This bill would help improve access to care by eliminating repeated prior authorizations for some patients, extending prior authorizations up to one year or the course of treatment and protecting patients from denials for approved care.
To help improve consumer transparency, the bill also requires carriers, private utilization review organizations, and pharmacy benefit managers (PBMs) to:
Publicly disclose information online about current prior authorization requirements including data on request determinations, exemptions, approvals, denials and prescription drug formularies
Annually review and eliminate prior authorization requirements for services and drugs that are commonly approved
Adopt a standard template to help patients understand their benefits
Additionally, this bill would also streamline care by alerting prescribers about what preferred medications are covered, including the specific prior authorization criteria. The goal of HB24-1149 is to reduce barriers to accessing health care by reducing the prior authorization requirements, especially for patients seeking medication or treatment they have already been prescribed.