Limits on Prior Authorization is MMA's Top Priority This Legislative Session

February 5, 2024

The state’s largest advocacy group for Minnesota physicians and physicians-in-training will be advocating for five legislative priorities at the Capitol this session, which begins February 12. The group will hold its annual Physicians’ Day at the Capitol on Wednesday, February 28, when hundreds of physicians and physicians-in-training meet with their elected officials.

“Many healthcare-related bills go through the Capitol each session,” said Laurel Ries, MD, the MMA’s president. “But to make an impact for patients and how medicine is practiced in Minnesota, we really need to focus our efforts on a few top issues. Reducing the use of prior authorization for critical services, where insurance companies delay getting treatments to patients, is the key one this year.”

The Minnesota Medical Association’s top priorities include:

Prohibiting the use of prior authorization for critical-care services. This includes eliminating the use of prior authorization for preventive services, generic drugs, outpatient cancer treatment, outpatient mental health/chemical dependency treatment, and medication-assisted-treatment (MAT) of opioid use. In addition, the MMA will work toward limiting prior authorization for chronic conditions to just a one-time approval, eliminating its use for value-based contracts, and eliminating prior authorization for providers whose approval rates are within the norm for approvals.

Limiting mid-year formulary changes for prescription drugs. This ensures that patients can't be forced by their insurer to change medications until the end of their health insurance contract. It also requires that health plans use “real-time benefit tools” to inform practitioners whether a prescribed drug is covered. If patients are obligated to remain on their insurance through their contract year, health insurance companies should not be allowed to change coverage in the middle of the contract year.

Promoting physician wellness services. This includes prohibiting credentialling applications from asking applicants about past health issues; protecting medical information disclosed as part of SafeHaven, the MMA’s new confidential, physician wellness program; and funding a public awareness campaign to encourage physicians to seek care. It also would include establishing a recognition program for hospitals and systems that promote workforce wellness.

Implementing and funding an electronic registry for POLST (Provider Orders for Life-Sustaining Treatment) forms. This is needed to ensure that patients’ wishes are followed by all physicians and other providers at end-of-life. Currently, providers only have access to paper copies of these critical medical orders. A statewide database is needed so these forms can be accessed at any time.

Addressing substance use morbidity and mortality through a public health lens by supporting the legislative work of the Harm Reduction Collaborative. This would include promoting the use of MAT in prisons, jails, and sober homes; and strengthening Minnesota’s Good Samaritan law for seeking help during a drug overdose and providing safe recovery sites.

About the Minnesota Medical Association
The Minnesota Medical Association is a non-profit professional association representing physicians, residents and medical students. With more than 10,000 members, the MMA is dedicated to being the indispensable and unified voice of physicians for advancing the practice of medicine, the profession and patient health.