Michigan Legislature votes to speed health care approvals

Doctor shortage 110819
Posted at 6:00 PM, Mar 24, 2022
and last updated 2022-03-24 18:00:43-04

LANSING, Mich. (AP) — Michigan insurers that require health providers to get pre-approval to cover treatment would have to promptly respond to doctors' requests or they would be automatically granted under a bill headed to Gov. Gretchen Whitmer for her expected signature.

The legislation received final, unanimous Senate approval on Thursday.

Advocates said the measure would speed delays in care and provide more transparency around the process known as prior authorization.

Starting in June 2023, a non-urgent request would be deemed as granted unless an insurer acts to grant or deny it or requires additional information within nine days. The time limit would drop to seven days beginning in June 2024.

Insurers would have to post their prior authorization requirements and restrictions, including clinical review criteria, on their websites.

Doctors and health advocates have complained that the process delays care, frustrates patients, and creates unnecessary red tape and expense for providers. The cost controls, which insurers have defended as essential, can affect people living with a range of chronic conditions and diseases including heart disease, cancer and diabetes.

Insurers have said they are trying to ensure that the most clinically appropriate care is being provided amid medical advances and an explosion in drug costs that are driving up premiums.