Chris Andersen
Nevada
As a parent of a child with juvenile arthritis (JA), it’s disheartening to learn of the Iowa Insurance Division’s proposed rule for prior authorization of prescription medications by Iowa insurers. My 14-year-old daughter, Nikole, was diagnosed 10 years ago with JA. She’s had both hips replaced, three knee procedures, countless needles and injections along with hospital stays and missed school days. Her battle has been long and her medications are essential for her treatment.
The Insurance Division’s proposed rule would make you or a loved one wait up to three days to access medications or care for which waiting could either “seriously jeopardize the life or health of the patient or the ability of the patient to regain maximum function.”
Even worse, if your doctor determines that you would be subject to “severe pain” that cannot be adequately managed without care or treatment that is the reason for the authorization request – the request still doesn’t have to be resolved for three days.
While three days for urgent authorizations could seem like a short time, three days without a critical prescription could launch Nikole into a serious arthritis flare, rendering her immobile and in immense pain.
I do not want my child to be in severe pain for a single moment, forget three days, while an insurer evaluates the request. Imagine even worse yet, after three days your insurer denies authorization and you have to go through further delay of an appeals process.
This proposed rule is bad policy for people with arthritis but will impact anyone that requires prior authorization of medications. This includes people with cancer, asthma, diabetes, cardiovascular disease, leukemia, psoriasis, lupus and other serious conditions.
But there is something that can be done. The Iowa Insurance Division is asking for public comment through Tuesday. This can be done via email (angela.burke.boston@iid.iowa.gov), phone call (515-281-4119) or at the Tuesday public hearing (10 a.m. IA Insurance Division, Two Ruan Center, 601 Locust, 4th Floor, Des Moines.)
The Insurance Commissioner needs to get this issue right and limit the prior authorization process to no more than 24 hours or, in the best case scenario, deemed automatically granted if urgent. I ask that the Iowa Insurance Commissioner take Nikole’s situation into consideration, and the thousands of other Iowans impacted, when addressing the proposed rule on prior authorization.