Politics Ensuring patients have timely access to necessary medical care
BETTER Kidney Care Act offers bipartisan solution to help dialysis patients
From my time serving in the Wisconsin Senate and later as governor, I know that passing major healthcare legislation can be a long, difficult process. However, I also know there are certain areas in healthcare where there is genuine bipartisan agreement and a willingness to come together to help patients. We’re seeing that now, and it’s time for lawmakers in Washington to take action and help a particular group of patients that desperately need it: kidney patients.
As both a 24-year Army veteran and an ophthalmologist, I understand the importance of the doctor-patient relationship. I have seen firsthand the need for patients to receive timely treatments. However, prior authorization has created unnecessary administrative burdens for physicians and has ultimately delayed necessary medical care for patients. As a result, this compromises the relationship between the doctor and the patient.
Throughout my time in Congress, I have heard from patient groups, health care providers, and health plans about the urgent need to deliver meaningful change. Because I understand the severity and importance of this issue, I am proud to support, along with a bipartisan group of colleagues, , which will help ensure Americans get the health care services that they need.
Hospitals weigh COVID vaccine mandates for patients in need of lifesaving organ transplants
Hospitals that perform organ transplants might add COVID shots to list of strict requirements and prioritize patients based on a range of factors.Hospitals that transplant hearts, livers, lungs or other organs have strict requirements and prioritize patients based on a range of factors, including medical need, suitability and likelihood of success.
Unfortunately, prior authorization can create delays and disruptions for a prescribed treatment that may be lifesaving to an individual. According to an American Medical Association (AMA) survey, about due to prior authorization and approximately 30 percent of physicians have reported that it has led to a serious adverse event for a patient.
Recently, thousands of Aetna Medicare Advantage beneficiaries have seen a delay in their cataract surgery due to a that went into effect this past July. Ophthalmologists who perform cataract surgery know that it is a common and highly successful procedure that restores a patient's vision. Without this surgery, it would be extremely difficult for an individual to perform daily activities without injuring oneself, and some patients may rely on family members for assistance. Aetna's prior authorization policy for all cataract surgeries goes against objective, evidence-based clinical criteria that was developed by the American Academy of Ophthalmology.
Doctors grow frustrated over COVID-19 denial, misinformation
The COVID-19 patient's health was deteriorating quickly at a Michigan hospital, but he was having none of the doctor's diagnosis. Despite dangerously low oxygen levels, the unvaccinated man didn't think he was that sick and got so irate over a hospital policy forbidding his wife from being at his bedside that he threatened to walk out of the building. Dr. Matthew Trunsky didn’t hold back in his response: “You are welcome to leave, but you will be dead before you get to your car,’” he said.
Prior authorization already creates a lot of paperwork for physicians and their practices, but excessive prior authorization makes that task even more burdensome. When insurers deny coverage, doctors and staff alike spend many hours on the phone attempting to appeal the decision. I have heard scenarios from my physician constituents where a practice will take time to submit a prior authorization request, receive approval from the patient's insurance company, and perform the procedure. Yet, days later, after submitting the claim, will receive a letter from the insurer claiming there was no approval. As a result, the physician and practice now must take more valuable time away from interacting with patients to deal with regulatory red tape.
In the 2020 AMA survey, a physician spends and the cost of prior authorization is estimated from $2,200 to $80,000 per physician each year.
Day care facilities are mandating COVID vaccine. Will they find enough staff to stay open?
Parents have already been weathering a shortage of child care providers. Vaccine mandates could make it harder for day care centers to hire staff.“There was a lot of sadness, but I did not ever question that it was the right decision for the children,” McCollum said.
I recognized the need to address the issue of overly burdensome prior authorization requirements, which is why I am proud to support H.R. 3173, the Improving Senior's Timely Access to Care Act. This bill would create a more transparent process of Medicare Advantage plans prior authorization and would hold insurance companies accountable to delays and denials in care.
I urge my colleagues in Congress to take the first step to streamline the prior authorization process by quickly passing H.R. 3173, so that we can ensure that patients get timely access to care and to have a better relationship with their doctor. As a state senator in Iowa, I passed needed reforms in prior authorization that were ultimately beneficial to both the patient and the physician and were not a costly expense. It is vital that we take similar action now to ensure patients have timely access to necessary medical care.
Miller-Meeks represents Iowa's 2nd District.
Colorado First State to Include Gender Affirming Care as Essential Health Care Benefit .
"Health care should be accessible, affordable and delivered equitably to all, regardless of your sexual orientation or gender identity," Chiquita Brooks-LaSure said.State officials announced their new plan under the federal Centers for Medicare & Medicaid Services (CMS) on Tuesday with the support of the federal government. Gender confirmation procedures, including jaw, cheek and eye modifications; face tightening; facial bone remodeling for facial feminization; breast or chest construction and reductions; and laser hair removal are included in the plan.