The House Insurance Committee convened Tuesday morning, and Representative Kevin Miller (R-Newark) provided sponsor testimony in support of HB 214, the prior authorization gold card legislation, before the House Insurance Committee.

Rep. Miller’s testimony explained to the Committee that House Bill 214, much like its predecessor in the previous general assembly, aims to set up a system which would reward physicians and healthcare providers with high prior authorization approval rates, reducing burdens & improving care. Under HB 214, high-performing providers would receive a “gold card,” which would allow them to, for a specific drug, device, or service that has been approved at a rate of at least 90% in the prior 12-month period, bypass prior authorization requirements entirely.

In his sponsor testimony, Rep. Miller cited several powerful statistics collected by the American Medical Association in their 2021 AMA Prior Authorization Physician Survey:

• 93% of physicians report care delays as a result of prior authorizations.
  
  
• 82% of physicians report that prior authorization can lead to treatment abandonment.
  
  
• 34% of physicians reported that prior authorization has led to a serious adverse event for their patients.
  
  
• 24% of physicians reported that prior authorization has led to a patient’s hospitalization.
  
  
• 51% of physicians treating patients in the workforce report that prior authorization has interfered with a patient’s ability to perform their job responsibilities.
  
  
• 88% of physicians describe the prior authorization burden as high or extremely high.

Last general assembly, over 30 organizations, including OSMA and other provider groups, hospitals, and patient advocacy groups, supported the prior version of this legislation. Our coalition in support of HB 214 is still growing, and we anticipate even more organizations will be a part of supporting the “gold card” legislation during this session. Momentum is building and we are working together to help eliminate unnecessary red tape that has burdened the physician community and their patients for far too long!

We appreciate Rep. Miller’s leadership and reintroduction of this important piece of legislation. If you have questions or would like to get involved in advocating for HB 214 or other insurance reforms, email info@osma.org or call our office at 614-527-6762.