Pisciottano supports bipartisan bill to help patients & doctors

Legislation would expand health care pre-authorizations

Rep. Nick Pisciottano    October 31, 2022 | 2:12 PM

HARRISBURG, Oct. 31 – As a longtime proponent of health care access and affordability, state Rep. Nick Pisciottano, D-Allegheny, voted to support a bipartisan bill that will help families and doctors by expanding health insurance pre-authorization for patients.

“This bill is a win for patients and their doctors because it will remove barriers and make sure people can access the essential medical care they need,” Pisciottano said. “This bill was a true bi-partisan effort, one which brought together not just lawmakers, but doctors, hospitals and insurance companies. We need to continue to do all that we can to make health care in Pennsylvania not just accessible, but affordable, as well.”

Some of the bill’s highlights include:

  • Allowing doctors to bill insurance companies for “closely related procedures” – meaning if a patient is getting care for an already covered issue and the doctor identifies a condition that could lead to future complications, the doctor can address the condition immediately without having to get a second authorization for a service.
  • Making sure patients get a simple, easy-to-understand explanation when payment for a procedure is denied, including outlining the patient’s rights and options.
  • Giving patients who are denied payment the ability to appeal the denial to the Pennsylvania Insurance Department instead of just the insurance company itself.
  • Requiring all denials to be reported to the department.
  • Ending no-exceptions medication policies that require patients to “try and fail” an ineffective prescription before getting the medication that works.
  • Ensuring patients going to out-of-insurance-network providers for coverage are reimbursed as quickly as a doctor’s office would be reimbursed to cut down on the out-of-pocket expenses.

The bill has passed both the House and Senate and has been sent to the governor’s desk.

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