Robert F. Kennedy Jr., Secretary of Washington-Svetyat and Human Services, said on Monday that the largest health insurers in the country have promised to make measures to simplify the frequently criticized process of previous publishing, which may postpone or deny patients’ access to supervision.
Previous edition is a cost reduction measure used by health insurers requiring them to sign tests, procedures or drugs so that patients can receive them.
Insurance tactics drew the attention of last year after the deadly shooting of Brian Thompson, CEO of New York City in New York.
Patients and doctors say prior edition creates too many obstacles, so people make people wait for days or weeks to get the treatment they need or completely deny them.
According to the KFF survey of the Health Policy Research Group, about 1 in 6 insured adults say they had prior permits.
Kennedy said a number of large insurance companies, including Blue Cross Blue Shield Association, CIGNA, Eleven Health, Guidewell, Humana, Kaiser Permanent and Unitedhealthcare, have committed amendments to be made through private insurance Medicaid.
The Health Insurance Industry Trade Group AHIP said changes can be useful for 257 million people in the US.
However, the experts emphasized that the prior permission did not disappear.
It is “going to simplify it only in a certain way,” said dr. ADAM GAFFNEY, critical care doctor and associate professor at Harvard Medical School.
Health insurance companies have assumed similar obligations to remedy the pre -edition of the past, the fact Kennedy and Dr. MEHMET OZ, Medicare & Medicaid Services (CMS) Administrator, recognized on Monday at the media event. 2018 And again in 2023. Health insurance companies have committed their obligations to reform prior permission, Oz said, but many have failed to comply with such reforms.
When asked what’s different this time, he said, “There is violence on these issues on the streets,” he mentions the shooting of Thompson.
Ahih – Former American Health Insurance Plans – described in detail health insurance companies committed to a press release earlier Monday.
Since next year, if patients switch insurance plans when they are treated, their new plans will honor existing previous permits for similar care for up to 90 days. In addition, next year, insurers will have to provide easier explanations when they deny authorization and offer tips on how to apply.
The insurers have committed themselves to the medical professionals to review all the denials of permits, although AHIP said it is something that insurers are already doing.
Insurers also undertook to simplify the previous edition process that by 2027 It would be easier to submit applications online. At least 80% of electronic queries will be answered in real time until 2027, ”Ahip reported.
Plans can also reduce the number of medical services that are subject to pre -editions in certain cities or states – although specific obligations on what may include.
Chris Klomp, who runs the CMS Medicare program, said the agency would like insurers to recover previous services, including colonoscopy, cataract surgery and childbirth.
Kennedy also stated that CMS cooperates with insurers to facilitate prior permission for diagnostic imaging, physical therapy and outpatient operations.
Gaffney criticized promises, saying that insurers had to change their practice for decades.
“Speaking is cheap,” said Gaffney. “There will be a major reform to eliminate obstacles to insurance companies as a result.”
Kaye Pestai, Director of KFF Patient and Consumer Protection Program said some obligations may have a direct impact on patients, such as honoring existing previous permits for three months after patients switch to insurers.
This article was originally published in nbcnews.com