Prior authorization for coverage of physical therapy, occupational therapy, speech therapy, chiropractic services, and other services under health plans.
Impact
The implementation of AB507 is expected to create significant changes in how health plans in Wisconsin manage claims for the specified services. By limiting the prior authorization requirements, the bill aims to improve patient access to necessary therapies and reduce delays in treatment. Proponents argue that this will streamline processes, reduce administrative burdens on healthcare providers, and ultimately provide better patient outcomes by facilitating quicker access to care. Additionally, the bill ensures that providers are properly compensated for the administrative work involved in managing patient data and care requests.
Summary
Assembly Bill 507 focuses on regulating the prior authorization processes for physical therapy, occupational therapy, speech therapy, and chiropractic services under health benefit plans in Wisconsin. This legislation mandates that health plans must issue decisions on reauthorization requests within 48 hours, failing which the prior authorization is automatically considered granted. Furthermore, it prohibits health plans from requiring prior authorization for the first 12 visits of the aforementioned therapies and for nonpharmacological pain management for chronic pain patients during the initial 90 days of treatment.
Contention
However, there are potential points of contention regarding the new regulations. Critics may argue that the absence of prior authorization could lead to an increased burden on healthcare resources, possibly resulting in overutilization of these services which could drive up overall healthcare costs. Additionally, the mandate for timely decisions may strain the existing resources of some insurance companies, as they may need to adjust their operational frameworks to comply with this new law. Balancing access to healthcare while ensuring sustainability of service provision remains a crucial debate surrounding AB507.
Prior authorization for coverage of physical therapy, occupational therapy, speech therapy, chiropractic services, and other services under health plans.
Prior authorization for coverage of physical therapy, occupational therapy, speech therapy, chiropractic services, and other services under health plans.
Prior authorization for coverage of physical therapy, occupational therapy, speech therapy, chiropractic services, and other services under health plans.
Occupational therapy services, occupational therapists, and occupational therapy assistants added to mental health uniform service standards, mental health services, and children's mental health grants.
An Act To Amend Title 18, Title 24, Title 29, And Title 31 Of The Delaware Code Relating To Insurance Coverage For Physical Therapy, Occupational Therapy, And Neuromuscular Massage Therapy.