Hundreds of forms cause delays, pain and suffering to patients waiting for relief
SPRINGFIELD, IL -- February 3, 2014 – Cancer patients waiting in pain for relief … quality of life being compromised … these are just a few of the concerns legislators will hear Wednesday, February 5th when the Illinois House Human Services Committee takes up a bill designed to standardize the hundreds of different forms used by insurance companies to authorize medical treatment.
Health advocacy organizations from around the state are urging the Illinois General Assembly to support House Bill 3638 sponsored by Rep. Laura Fine (D-Glenview) and Senate Bill 2585 sponsored by Senator Dan Kotowski (D-Park Ridge) and Senator Mattie Hunter (D-Chicago) to ensure prompt patient access to life-saving medications by streamlining the prior authorization process in the state – a process where patients must wait until the insurance company approves the use of a medication recommended by their physician. It has meant mounds of paperwork for doctors and nurses, and days, even weeks, of delays for patients seeking critical care.
According to a 2010 American Medical Association survey on prior authorization, physicians and staff spend about 20 hours per week on average dealing with prior authorizations. In Illinois alone, there are more than 300 different forms used by various insurance companies for prior authorization, which according to health care providers, is causing alarming, even dangerous delays in access to medication.
“The prior authorization process can absolutely have an impact on the health of our patients,” said Nancy Leone, a registered nurse in Antioch. “Recently, a patient needed a specific type of chemotherapy for abdominal cancer. It was denied by the insurance company, and then it took about a month of waiting and back and forth before the patient was finally approved and could receive it.”
At least 20 Illinois health advocacy organizations, representing tens of thousands of patients, have sent a letter to the Illinois General Assembly supporting HB 3638 and SB 2585 and stating, in part:
Standardization of prior authorization should be part of Illinois’ efforts to improve health care and reduce costs, as it has clear implications for improved efficiency and enhanced patient outcomes. As organizations that represent a wide variety of patients, we urge you to support legislation that would standardize the state’s prior authorization system.
AIDS Foundation of Chicago
American Cancer Society-Cancer Action Network
American Heart Association/American Stroke Association
American Lung Association of Illinois
American Nurses Association of Illinois
Chicago Hispanic Health Coalition
Epilepsy Foundation of Chicago
Epilepsy Foundation of North Central Illinois, Iowa and Nebraska
Epilepsy Foundation of Greater Southern Illinois
Epilepsy Therapy Project
Gateway Hemophilia Association
Gilda’s Club of Chicago
Illinois African American Coalition for Prevention
Illinois Psychiatric Society
Illinois Rural Health Association
Illinois Society for Advance Practice Nursing
Leukemia and Lymphoma Society-Gateway Chapter
Leukemia Lymphoma Society of Illinois
Lupus Foundation of America-Illinois Chapter
Mental Health America of Illinois
NAMI Greater Chicago
State Pain Policy Action Network
"There have been times when I've had to wait for up to three weeksafter requesting my prescriptions, because the doctor must fill out any number of forms and wait for approval from the insurance company," said Columbia resident and arthritis sufferer Kim Kitowski. "Access to medication is critical to my ability to go to work, care for my twin boys – live my day-to-day life."
HB 3638 and SB 2585 would amend the Illinois Public Aid Code and the Illinois Insurance Code and require the Department of Healthcare and Family Services and the Department of Insurance to jointly develop a uniform prior authorization form for prescription drug benefits on or before July 1, 2014.
“Pain remains one of the most feared and burdensome symptoms for cancer patients and survivors, and waiting for prior authorization approval can have significant negative impacts on a patient’s treatment and quality of life,” said Heather Eagleton, director of public policy & government relations of the American Cancer Society-Cancer Action Network. “When a person has a disease like cancer, they need to be focusing on getting better and fighting the disease, not administrative barriers to care.”