Legislation to reform the prior authorization (PA) process cleared committees in both the House and Senate in recent days. The MNAAP-supported bill includes several provisions intended to assist in ensuring patients receive timely care while also removing the administrative burden of prior authorization. The bills accelerate the timelines health plans are allowed to review PA requests, requires plans to post clinical criteria used for prior authorization, provides for a transition period for patients who change health plans, and several other provisions.
MNAAP leadership and staff continue to lobby the Minnesota Department of Human Services (DHS) for flexibility in how Child & Teen Checkup (C&TC) visits are reimbursed given the dramatic increase in these visits being done via telemedicine, meaning some services otherwise part of the C&TC bundled payment cannot be completed. The MNAAP has lobbied the administration to reimburse for these visits at the full rate with the expectation that the services will be provided at the patient’s next visit. DHS has indicated that they face several challenges in accommodating the request.
Gov. Tim Walz continues to use his executive authority to enact time-limited changes in many areas and industries. In addition to recently extending the “stay at home” order for several weeks, he also acted to allow physicians and nurses from other states to practice in Minnesota during the peacetime emergency. Another order modified an earlier executive order prohibiting elective surgeries and procedures. The new order allows such procedures to go forward if certain conditions regarding personal protective equipment (PPE), screening and testing capacity, and other metrics are met. The MNAAP assisted in making recommendations to the governor.
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