Sandra Johnson was responding well to an injectable drug to treat her persistent asthma, but then her insurance company stopped allowing her to get it in a process called"prior authorization."Sandra Johnson was responding well to an injectable drug to treat her persistent asthma, but then her insurance company stopped allowing her to get it in a process called"prior authorization.
States are responding to complaints from physicians and patients, and pursuing legislation to try to set some ground rules on prior authorization. New Jersey was the second state to pass this kind of legislation afterThe drug Johnson had been on made a big difference in her quality of life. She says she felt better and could go back to her job as a clinical coordinator, do chores and go grocery shopping without trouble.
"This causes so much moral distress that I often go home, and I have to decompress because I know that I can be the best doctor, but because of prior authorizations I often can't deliver the best care," she says. Catherine Trillo has been a registered nurse in New Jersey for more than 30 years, and says she sometimes spends hours each day dealing with this issue on behalf of patients. She says the reform bill will make a big change for patients and medical staff.
Ward Sanders represents the health insurance companies in this debate, as the president of the New Jersey Association of Health Plans.
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