NJ Spotlight News
NJ bill would ban pre-approval from health insurance
Clip: 12/17/2024 | 4m 48sVideo has Closed Captions
New law will reduce pre-authorization delays in some cases, lawmakers pressing for more
A new state law that will take effect Jan. 1, will reduce insurance pre-authorization delays by requiring companies to respond within 24 hours, in some urgent cases. But state Sen. Jon Bramnick (R-Union) and co-sponsor Senate President Nick Scutari (D-Union) have been pushing a more comprehensive pre-authorization ban bill for years.
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NJ Spotlight News is a local public television program presented by THIRTEEN PBS
NJ Spotlight News
NJ bill would ban pre-approval from health insurance
Clip: 12/17/2024 | 4m 48sVideo has Closed Captions
A new state law that will take effect Jan. 1, will reduce insurance pre-authorization delays by requiring companies to respond within 24 hours, in some urgent cases. But state Sen. Jon Bramnick (R-Union) and co-sponsor Senate President Nick Scutari (D-Union) have been pushing a more comprehensive pre-authorization ban bill for years.
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Learn Moreabout PBS online sponsorshipwell anyone who's gone through a major health struggle can likely attest it's not just a health issue you're battling it's often the insurance companies approving your care it's a conversation that's come into focus in light of the recent killing of United Healthcare CEO Brian Thompson yesterday one prominent new jerseyan shared his story Brad Schnure the former Senate Republican communications director held a virtual press conference to share how he had to battle his insurance provider after his cancer diagnosis senior correspondent Brenda Flanagan has his story I was denied a relatively inexpensive scan that could have caught my cancer when it was still curable I want to make sure that nobody else has to go through that Brad Schnure's battling terminal lung cancer a disease he believes progressed undiagnosed to stage four partly because his health insurance denied coverage for a CAT scan in 2022 before the cancer had spread that same year a survey showed more than 90% of doctors report reported patients had delayed healthcare because insurers denied prior authorization public frustration over the issue exploded after the recent assassination of United healthcare's CEO all the response to the death of Brian Thompson I think that people are outraged and they're not afraid to do something about it and they're not afraid to tell people that you know the system is so wrong that you know we're going to we're going to go out and do bad things and I don't think that should happen Schnure expressed his alarm in an op-ed piece that ran on nj.com urging a legislative Solution co-sponsored by Republican senator Jon Bramnick the bill prohibits Health insurers third-party administrators Pharmacy benefits managers and other plans from requiring the pre-approval of medical tests procedures or prescription drugs covered under a health benefits or drug benefits plan Bramnick who's running for governor says it will be an pill fight and I know I'm right but the insurance Lobby and the insurance companies is extremely powerful extremely powerful but what what is right is right and I want doctors making decisions with patients not bureaucrats at insurance companies Bramnick has been pushing the bill for years saying lawmakers have usually approached the problem peace meal targeting specific medical tests and treatments in fact a new law will reduce Insurance pre-authorization delays by requiring answers within hours on urgent cases in New Jersey Bramnick not swayed by industry arguments that some doctors go overboard on expensive testing if there are doctors that are overdoing tests that are unnecessary tests then the doc then the insurance company should identify those outliers and those outliers should be reigned in and they should be subject to pre-approval but prior authorizations not just red tape according to an industry executive who stated its goal is to provide the Right Care at the right time and the right setting and to allow for the efficient allocation of resources I think that the insurance company's view of cost savings uh derived from prior authorization is extremely shortsighted New Jersey's Medical Society Council notes the time spent by nurses and doctors and insurance company staff wrangling over treatment requests just drives up costs for both sides and patients if they're not getting the care they need when they need it I think the the the clear answer is to reduce this level of waste so that the entire system is functioning better and serving patients better and delays in needed Health Care end up costing everyone more you have patients who can end up back into the hospital without the medication that that they need um and so so really it it comes down to what we need to do for patient care and streamlining the process is really what's in the patient's best interest the third- party company that denied Schnure's CAT scan Evie core didn't reply to requests for comment Schnure says the company still argues with his doctors at Sloan Kettering over treatment I get another denial letter probably every three months Schnure who left his job at with the state House's head of communications for Senate Republican says he will keep pushing for reforms I'm Brenda Flanagan NJ Spotlight news [Music]
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