Pre-authorization: Keep it, with reforms

To the editor:

If you or someone you know has ever experienced the frustration of a delayed medical procedure or a denied prescription due to prior authorization, you’re not alone.

That’s why Indiana lawmakers are considering changes. House Bill 1003 offers targeted, common-sense reforms that streamline prior authorization and improve transparency, while Senate Bill 480 would significantly limit its effectiveness — and increase healthcare costs.

Prior authorization is one of the few tools to keep healthcare costs in check, ensuring that treatments are medically necessary and cost-effective. It can direct patients toward clinically proven, lower-cost medications, reducing prescription costs by as much as 80%. It also ensures that MRIs and CT scans are obtained at facilities offering the best patient value.

The financial implications of limiting prior authorization are considerable. According to a 2024 report, Indiana’s employer-sponsored health plans could see costs increase by up to $241 million annually, potentially leading to raised premiums or reduced benefits. Similarly, Indiana’s Medicaid program could face an additional $395 million in costs each year, putting a strain on the state budget and diverting resources from other essential services.

Patients deserve faster, fairer, more transparent medical care. Lawmakers can achieve that by fixing prior authorization with HB 1003.

David Ober

Senior vice president of business operations and finance

Indiana Chamber of Commerce