Pass HB 1194/SB 940 to Streamline Prior Authorization and Improve Patient Care


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Pass HB 1194/SB 940 to Streamline Prior Aurthorization and Improve Patient Care

Dear [Decision Maker],

As a constituent and volunteer for the American Cancer Society Cancer Action Network, I ask you to pass HB 1194/SB 920. This bill would curb restrictive prior authorization and step therapy (fail first) practices imposed by health insurers two harmful practices that delay approvals for prescribed medications and treatments, putting patients at severe risk.

During a virtual press conference earlier this week, fellow Pennsylvanian Faye Parker, a Stage III melanoma cancer survivor, talked about her firsthand experience with delays in access to tests and treatment. -As Faye put it, "Cancer patients such as me are already fighting for our lives. We cannot afford to wait on insurers to approve tests or treatments ordered by doctors--as those delays can cost us precious, lifesaving time."

There is currently no requirement in state law that prior authorizations be made in reasonable timeframes and there is no clear step therapy exemption process. The current one-size-fits-all approach to controlling health care costs can and does lead to unnecessary delays, even denials, of care. Requiring Pennsylvania patients' health to deteriorate as they await authorization or try and fail on medications that don't work for them is simply unacceptable.

In national surveys conducted by the American Medical Association:

92% of physicians reported prior authorization had a negative effect on patient clinical outcomes
78% of physicians reported that prior authorization can lead to patients abandoning a recommended course of treatment

This legislation would ensure that prescribers have access to more efficient electronic prior authorization systems ("ePA") and shorten the approval period to expedite the prior authorization process, reducing administrative burdens for physicians, and ultimately, better serving patients in the health care system.

In addition, it would ensure that fail first protocols are based on clinical guidelines developed by independent experts, establish a basic framework for when it is medically appropriate to exempt patients from fail first, and ensure that the exceptions process is transparent and accessible to patients and health care providers.

I hope I can count on you to support HB 1194/SB 940 to improve patient care and ensure that cancer survivors like Faye get the treatments they need, when they need them.

[Your Name]
[Your Address]
[City, State ZIP]
[Your Email]