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Illinois State Medical Society Promotes Legislation On Prior Authorization

A person in a white coat with a stethoscope around their neck.
The rule would clarify how prior authorization procedures work.

The Illinois State Medical Society is hoping new legislation will make it easier for patients to get timely medical care.

The proposed legislation would make changes to the prior authorization process used by insurance companies. Medical Society President Robert Panton said the goal is not to eliminate prior authorization, but to make it more transparent and streamlined. He said current processes can delay care.

“We have reports of oncology, which is cancer treatment, taking up to a month in order for the treatment to be approved and started,” he said.

The proposed law would put time limits on approval for urgent and non-urgent procedures, require a publishable list of procedures that require authorization, and exempt certain routine tests and procedures from requiring prior approval. It would also make sure that prior authorization for a procedure would be a guarantee that the service will be paid.

The legislation has bipartisan support and Panton is hopeful that it will move forward as the General Assembly resumes normal activity that was paused due to the COVID-19 pandemic.

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