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DENVER, CO – The House Health and Human Services Committee today passed legislation to streamline access to health care. HB24-1149, sponsored by Representative Shannon Bird, would modify requirements for prior authorization of certain procedures and prescription drugs so Coloradans can receive the care they need.
“We need to remove unnecessary barriers to accessing health care, and this legislation eases prior authorization requirements so Coloradans can receive the care they need faster,” said Rep. Shannon Bird, D-Westminster. “We know prior authorization requirements can cause delays in care, and this bill would modify some requirements and alert prescribers about medication preferred by patients ahead of time. This bipartisan legislation would also improve health insurer transparency so patients have a better understanding of what certain health care insurers cover and what they do not.”
HB24-1149, also sponsored by Representative Lisa Frizell, R-Castle Rock, passed by a vote of 10-2. It would improve Colorado’s prior authorization requirements to streamline health care services, procedures and prescription drugs for patients. Due to health care insurer requirements surrounding prior authorization, 94-percent of physicians report care delays because of prior authorizations. This also leads to an overall increase in treatment abandonment by patients. This bill would help improve access to care by eliminating repeated prior authorizations for some patients, extending prior authorizations up to one year or the course of treatment and protecting patients from denials for approved care.
To help improve consumer transparency, the bill also requires carriers, private utilization review organizations, and pharmacy benefit managers (PBMs) to:
Publicly disclose information online about current prior authorization requirements including data on request determinations, exemptions, approvals, denials and prescription drug formularies
Annually review and eliminate prior authorization requirements for services and drugs that are commonly approved
Adopt a standard template to help patients understand their benefits
Additionally, this bill would also streamline care by alerting prescribers about what preferred medications are covered, including the specific prior authorization criteria. The goal of HB24-1149 is to reduce barriers to accessing health care by reducing the prior authorization requirements, especially for patients seeking medication or treatment they have already been prescribed.