Senate District 31
Jay Hottinger
Insurance Prior Authorization Reforms Seek to Provide More Efficient Medical Treatment for Ohioans
A Guest Column by State Senator Jay Hottinger
January 7, 2016

Health insurance can be a complicated issue. Whether you are shopping for coverage or paying medical bills, the process of becoming – and staying – insured is often complex.     

As Chairman of the Senate Insurance committee, I understand the challenges facing many consumers as they navigate the health insurance market. This past year, I had the opportunity to oversee the passage of Senate Bill 129 out of the Senate Insurance committee. This legislation, sponsored by my colleagues Senators Randy Gardner (R-Bowling Green) and Capri Cafaro (D-Hubbard) makes several important changes to how prior authorization is handled by health insurers.

Prior authorization (PA) requires health care providers to ask permission from a patient’s insurance company before performing certain treatments or prescribing certain medications. Currently, this process causes a large administrative strain on medical practices. At times, it even leads to delays in diagnosing and treating patients.

SB 129 seeks to make prior authorization more transparent, simple and patient-focused. This encompasses several aspects of the PA process. The bill would ensure that all PA requirements and restrictions are listed for consumers on the health insurer’s website and establish a web-based system to allow patients and providers to obtain prior authorization. Other provisions include barring an insurer from retroactively denying a PA once it has been approved and guaranteeing a faster and more efficient turnaround process on PA requests. 

The legislation has been sent to the House of Representative where it is expected to receive further consideration.

If signed into law, Ohio would join 15 other states that have taken similar measures in addressing the complicated issue of prior authorization. Senators Gardner and Cafaro and I have spent months working with both health care providers and health insurers to focus on the needs of both physician practices and health insurers. I am pleased with our finished product thus far and I am proud of this bipartisan effort to make certain that you, the consumers, are getting fair and transparent treatment in the PA process.

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