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Senate passes DiMario bill to streamline prior authorization process in health care

STATE HOUSE — The Senate today passed legislation introduced by Sen. Alana M. DiMario (D-Dist. 36, Narragansett, North Kingstown) that would streamline the process for prior authorization in health care.

The bill (2021-S 0647) would require the Health Insurance Commissioner to adopt a uniform set of medical criteria for prior authorization and create a required form to be used by all health insurers.

“This will not only decrease administrative burdens on health care providers,” said Senator DiMario, “it will also connect people with their needed care faster. The process as it stands now can be cumbersome, since the provider has to make a case in writing to an insurance provider about why a prescribed medication, treatment or service is necessary. This legislation would mandate a uniform process for prior authorization, rather than have different insurance companies use different forms.”

The bill would also eliminate confusion when patients switch insurance companies or those companies change their prior authorization policies. These changes can lead to frustrating and even dangerous delays in treatment.

“Several years ago, we had a similar problem with billing claims forms, which are now standardized throughout the industry, since all insurance companies use the same form for billing purposes,” said Senator DiMario.

The measure now moves to the House of Representatives, where similar legislation (2021-H 5772) has been introduced by Rep. Brandon C. Potter (D-Dist. 16, Cranston).

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