Prior Authorization Reform One Step Closer to Finalization

April 30, 2021 - Following a single committee hearing this week, the Michigan Senate Health Policy and Human Services Committee passed Senate Bill 247. This bill is the newest iteration of prior authorization reform that MAFP has been working on independently and collaboratively through the Health Can’t Wait Coalition. The Senate then moved swiftly, passing the bill on Apr. 29, sending it to the House Health Policy Committee for consideration.

Last year, Senate Bill 612 passed the Senate during lame duck; however, there were many changes that removed enforcement mechanisms and reporting requirements, and the bill ultimately expired at the end of 2020.

The version of SB 247 that passed the Senate on Apr. 29 includes provisions for transparency, fairness, and clinical validity requirements. One of the larger changes between last year's SB 612 and this year's SB 612 is the removal of step therapy sections. It is anticipated that a stand-alone step therapy bill will be introduced later in this legislative session. The new SB 247 also includes data reporting requirements, such as mandating that insurers post prior authorization benchmarks on their websites.

As SB 247 moves to the House, it is expected to receive a more lengthy debate, since this is the first prior authorization legislation considered by the chamber. Throughout the process, the MAFP advocacy team will continue to ensure the prior authorization reform provisions are as robust as possible and protect patients' access to care while not putting additional burden on physicians.