The 2020 Florida Legislative Session kicked off earlier this month with confirmation that health care will remain at the center of the debate in Tallahassee. The Dade County Medical Association (DCMA) has been busy setting the table for a successful session by hosting a number of events and engagements with the Miami-Dade Legislative Delegation.
The DCMA is pursuing a pro-physician and pro-patient agenda in 2020. Legislation has been filed to provide common sense reforms to prior authorization, drug formulary switching, and step therapy protocols. We are also pursuing bills that will prohibit retroactive denials by insurance carriers for services they have previously authorized and we deliver in good faith.
A 2018 study published by the American Medical Association illustrates the detrimental impact that the expanding utilization of prior authorization has on the healthcare system. The study found that prior authorization processes cost the equivalent of more than two full workdays per week in physician and staff time; $82,975 per full-time physician annually; and $23 billion to $31 billion annually to the health care system which is absorbed by the government, employers and individuals that purchase insurance coverage.
Furthermore, the study found that one in four physicians (28 percent) report that authorization delays have led to a serious adverse event (such as hospitalization, disability or permanent bodily damage, or other life-threatening event) for a patient in their care. Most physicians (92 percent) also report that authorization requests have had significant, negative clinical impacts and delayed needed therapies and treatment within the past year.
We hope this is the year that the Florida Legislature acts to eliminate the harmful administrative actions taken by health insurance carriers that jeopardize the health and safety of our patients.
