OCMS Special Member Event

Lawmakers in Michigan, in Congress and around the country are debating the appropriate recourse to address unanticipated out-of-network bills. Patients are receiving these high bills because the care they believed was covered, actually was not. This is a problem, but it is also a complex issue tied up in provider-payer negotiations and market dynamics. Unfortunately, the sponsors of legislation introduced in Michigan – HB 4459 & 4460 and SB 570 & 572– believe there is a simplistic answer, namely implementing a fee schedule with no accompanying provisions for a physician to appeal a payment, nor any provisions to ensure network adequacy or health insurance benefit transparency. Click here to read more and get involved in this important legislation.

#FixPriorAuth because #HealthCantWait: Support SB 612

Prior authorization and step therapy/fail first requirements hamstring treatment, drive up non-adherence to medication and lead to diminished health. It’s onerous and needless insurance company bureaucracy, and it’s negatively affecting patients, physicians, providers and their practices.

It’s time we cut out the red tape, because at the end of the day, health can’t wait.

And now we can do just that.  

State lawmakers recently introduced SB 612, a bill that reforms the prior authorization and step therapy/fail first process by introducing new transparency, fairness and clinical validity requirements, ensuring our patients receive timely coverage decisions, and ultimately, the care and treatment they need.

This is the kind of reform our patients deserve—it’s time to put them first.

Please contact your lawmakers today and urge them to support SB 612.