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February 24, 2023

Many State Legislatures Target Prior Authorizations

December 2022, CMS published proposed rules to streamline prior authorizations by Medicare Advantage Plans and other federal programs.  Meanwhile, at least 40 states are expected to consider measures that would streamline the process of how doctors obtain authorization from insurers prior to ordering procedures, tests, or treatments. Medical providers often argue that the prior authorization process delays patient care and can cause adverse outcomes.  Health insurers argue that prior authorizations are necessary to be sure patients receive care they actually need and to reduce costs. An example of one such proposed law in New Jersey would exempt chronic condition treatments from prior authorization rules for the length of treatment.  As prior authorizations are huge concern for patients diagnosed with cancer, these laws will be watched closely by those in the cancer community. 

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