New legislation in West Virginia is aimed at tackling prior authorization hurdles under the state’s public employee insurance health plan. The move comes six months after a state employee died following repeated cancer treatment coverage denials, according to an April 1 report from KFF Health News.
House Bill 4965, which Gov. Patrick Morrisey signed into law March 31, will take effect June 10 and allow members covered by West Virginia’s Public Employees Insurance Agency to seek alternative, medically appropriate treatment of equal or lesser value to an already approved treatment without prior authorization.
West Virginia’s public employee health plan enrolls nearly 215,000 state workers, their spouses and dependents, the report said.
The law was inspired, in part, by the experience of Eric Tennant and his family. Mr. Tennant was repeatedly denied coverage for histotripsy, a less expensive alternative to chemotherapy. By the time the health plan reversed its decision, Mr. Tennant was no longer eligible for the treatment due to declining health. He died Sept. 27 at age 58.
A KFF Health poll published Feb. 2 found 69% of insured adults in the U.S. considered prior authorizations the biggest burden to accessing healthcare.
Read the full KFF Health News report here.
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