The Legislature moves bills on prior authorization, loan repayment, and broadband expansion

The Michigan Legislature’s spring break adjournment followed lots of bill movement. The Legislature moved bills to change the prior authorization process for commercial insurers, provide supplemental funds to implement statewide broadband, and expand the Essential Health Provider Loan Repayment Program. 

 

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Both chambers recently passed Senate Bill 247, which would decrease wait times for commercial insurance prior authorization requests. According to a letter written by the Michigan Health and Hospital Association (MHA), prior authorization has created challenges that “consistently delay care and negatively affect patient outcomes.”

MHA said a 2018 study found that prior authorization contributed to 92% of all care delays. The letter also said that only 5-10% of claims are ultimately denied for most facilities and that requirements for requests are constantly changing. This makes it challenging for providers to predict the likelihood for approval for patients in need of that medication or service. 

“The MHA believes that shortening the timeline for approval to seven calendar days, or 72 hours for urgent requests, will prevent delays in care and lower patient risk,” said the letter. “The MHA [also] believes that increasing prior authorization transparency and requiring notices for process changes will greatly improve provider efficiency.”

The passed bill will also allow emergency care to be provided without prior approval. The bill currently sits on Gov. Gretchen Whitmer’s desk.

The Legislature also recently passed Senate Bill 565, which appropriates $4.7 billion to various departments to improve infrastructure in the state, including broadband. 

The bill appropriates $250 million to expand statewide broadband services, including eight new FTE positions for the Michigan High-Speed Internet Office. SB 565 also appropriates $25 million for COVID response activities to the Department of Technology, Management, and Budget. 

The bill currently sits on Whitmer’s desk. 

Whitmer recently signed both Senate Bill 246 and Senate Bill 435 into law, which will expand the use of the Essential Health Provider Loan Repayment Program. The bills would increase the overall eligibility amount from $200,000 to $300,000.  

The bills would also amend the public health code to add “designated mental health professionals” to those eligible for loan repayment. “Designated mental health professionals” would mean any individual qualified in the area of mental illness or developmental disabilities and could be a nurse, psychologists, social worker, professional counselor, or marriage/family therapist.