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Prior authorization red tape and step therapy delays care and treatment for Michigan patients
Michigan physicians, clinicians, and health care providers see it every day. They examine patients, and together form a plan of care, often including additional tests, prescription medicines, and treatments – before insurance companies step in with prior authorization and step therapy red tape to prevent patients from immediately accessing the care they need.
When insurance company bureaucracy gets between a physician and his or her patient, patients get sicker, health conditions worsen, and the cost of care skyrockets. That’s not right. Health can’t wait, and we’re doing something about it.
We are excited this week to launch a groundbreaking new effort to improve patient care.
Health Can’t Wait is a coalition of patients, health care providers, and patient-support groups working together to put Michigan patients first by ending dangerous delays in patients’ access to health care caused by insurance company bureaucracy, including prior authorization red tape and step therapy requirements.
The coalition is being led by more than a dozen patient advocacy and health care organizations, including the American Cancer Society Cancer Action Network, Susan G. Komen Michigan, the Michigan State Medical Society, the Michigan Rheumatism Society and many, many more.
But we need your help!
There are three things you can do to make a difference.
First, share your story. Have you, a patient, or a member of your health care team witnessed or experienced a delay in care caused by prior authorization or step therapy? You can share your story – and your patients can share theirs – online at HealthCantWait.org. Your patients’ willingness to speak out about the impact insurance company red tape has had on their health couldn’t be more important, and sharing their story couldn’t be easier.
Second, share the news about the coalition and the importance of this reform. Share the website on social media. Speak out to your friends, family and colleagues, and consider reaching out to your own lawmaker to encourage reform. The team at MSMS is standing by to help you craft and share your story and to connect you directly with your state legislators.
The Health Can’t Wait coalition’s work couldn’t be more important. 94 percent of Michigan physicians report that prior authorization red tape causes delays in care for their patients. Prior authorization red tape is part of a staggering 92 percent of all care delays, and those delays can be devastating.
In fact, 78 percent of physicians trace prescription and treatment non-adherence to prior authorization delays. In other words, when red tape and bureaucracy prevents patients from timely access to the medicine and treatment they need, those patients are dramatically more likely to suffer the devastating health effects that come from nonadherence.
Sicker patients. More frequent visits to the emergency room. Longer hospital stays. Bigger bills. That’s not right. Health can’t wait.
Join us for the first AWIR meeting in Michigan.
You do not need to be a member of AWIR to attend and only the first hour is pharma sponsored.
The Let MI Doctors Decide initiative has released a new report card on the 25 largest health plans within Michigan’s Medicare prescription drug program. It examines the use of access restrictions, such as step therapy and prior authorization, on seniors with autoimmune diseases.
The new resource is particularly timely given the proposed rule issued by the Centers for Medicare and Medicaid Services (CMS) earlier this week that would broaden the use of step therapy within the Medicare program.
Let MI Doctors Decide is led by the Michigan-based American Autoimmune Related Diseases Association (AARDA) in partnership with five local patient advocacy and health care organizations. The initiative aims to help patients and doctors navigate step therapy practices. To learn more, visit letmidoctorsdecide.org.
Save the Date for the MRS Billing and Coding Course on Friday, April 27, 2018 at the Westin Southfield Detroit Hotel. Instructors will be Antanya Chung and Melesia Till from the American College of Rheumatology (ACR). This Rheumatology Billing & Coding Course, presented at the ACR’s Annually Meeting, will be complimentary for Michigan Rheumatism Society members and staff. More details to follow.
The Michigan Rheumatism Society CME Summer Conference will be held at the Grand Traverse Resort in Acme, Michigan on August 11 -13, 2017. We are excited about this year’s lineup of speakers and hot topics. You can earn up to 11 CME credits. There will be opportunities to network with your colleagues and learn about new products in the Exhibition Hall. New this year is the Scientific Exhibition Hall where you will be able to view scientific posters and have questions answered from the medical science teams of our pharmaceutical colleagues. There is a welcome dinner on Friday night and down time to spend as you wish throughout the weekend.
For any questions or to reserve a hotel room at the discounted rate call Tammy Guastella at 517-203-5560 or via email firstname.lastname@example.org. There are only a few discounted rooms available for Friday and Saturday nights at the Grand Traverse Resort so call today!
Amway Grand Plaza Hotel
Grand Rapids, MI
October 7-8, 2016