Indiana’s hospital prices rank among the highest in the nation, threatening access to care among escalating costs. Prior authorization is a tool used by managed care plans to ensure people are receiving the right care, at the right time, and in the right setting – keeping healthcare safe and more affordable.
There’s no question—Indiana families deserve to get the care they need. They also deserve to have safe, high-quality, and affordable care and protection against waste, fraud and abuse within the healthcare system. A good prior authorization system accomplishes all of these things.
Prior authorization defends Hoosiers against:
– Unnecessary or Inappropriate Care: Prior authorization ensures that treatments, tests, or medications are medically necessary and evidence-based, helping to avoid unnecessary or inappropriate care. This protects patients from receiving care that may not benefit them or could potentially cause harm.
– Fraud and Abuse: Prior authorization helps reduce the risk of fraud and abuse within the healthcare system by preventing providers from ordering expensive services or medications without proper justification, which could drive up costs for employers and patients.
– Increased Medicaid Expenditures: For Indiana’s Medicaid program, prior authorization helps manage limited resources effectively, ensuring that taxpayer dollars are spent on care that is truly necessary and appropriate. Without it, Indiana taxpayers could face higher costs, limited access, fewer services, or reduced coverage for beneficiaries.
– High Costs for Employers and Patients: By managing the use of costly treatments and medications, prior authorization helps keep healthcare affordable for both employers and employees. This is especially important in employer-sponsored health plans, which represents the majority of health plans in Indiana, where rising costs can lead to higher premiums or reduced coverage.
Indiana legislators are considering introducing legislation that would heavily limit the use of prior authorization. This would be a grave mistake. The financial implications for employers, employees, and the state’s Medicaid program are too significant to ignore.
We can’t afford to stand on the sidelines. Join our fight to defend Hoosier’s from higher healthcare costs.