LINCOLN, Neb (KMTV) — As an Oncologist Dr. Mary Wells wants to spend as much time as she can caring for her patients.
When one of her patients cancer began spreading she looked for options to treat him.
She found him a medication and sent it to insurance for prior authorization.
“7 days later, with his cancer getting worse day over day we were informed his insurance had denied the drug. But we could appeal, I did and five days later we received a note from his insurance company saying they were pleased to inform us the medication was covered by his plan,” said Dr. Wells.
But for Dr. Wells patient that wait for the original authorization was too long.
“Two days later he died in the hospital ICU of complications of has cancer progressing unchecked,” said Dr. Wells.
Wells was one of several doctors, patients and health administrators speaking out in support of LB77.
The bill looks to rein in the prior authorization process and speed things up for doctors like Dr. Wells and patients like Janel Fricke.
“I was in a car accident in 2013 and suffered an injury of my spine,” said Fricke.
Fricke had to wait 5 months for a prior authorization for surgery to correct her injury. LB77 if passed, would require insurers to respond to these requests within 12 hours for urgently needed care and 72 hours for non-urgent care.
But time isn’t the only obstacle that patients face with prior authorization. Many parents like Fricke are having their coverage denied by doctors with little to no expertise in the care that patients are needing.
LB77 would require insurers to put actual experts behind the prior authorization process. Something that Fricke said was critical to getting her surgery approved.
“Another peer to peer review with an actual neurosurgeon was scheduled. My surgery was finally approved,” said Fricke
