Overview
FHA supports fair and equitable payment models that reimburse for the cost of the high–quality care hospitals provide. FHA also opposes harmful, unilateral policy changes that can be implemented without guidance or warning and detract from swift access to health care services.
2023 Legislative Priorities
- Ensure payers are adhering to contractual standards governing prior authorizations, provider loading, and network adequacy.
- Reduce the number of unilateral policy changes that disregard patient safety and health outcomes.
- Require Medicaid managed care plans to report annually on the performance in health care outcomes.
- Support regulatory improvements to the 340B prescription drug pricing program.
Legislative Priorities
White Bagging
White bagging is a policy in which insurance companies require drugs to be purchased through a specialty pharmacy of the insurer’s choice and then ship those drugs to the hospital or infusion center where the patient will receive treatment.
Prohibiting white bagging policies by insurance companies will reduce instances of delayed care, minimize drug waste, and ensure drugs are safely and effectively administered to the patient.
Prior Authorization
Health plan prior authorization practices can unnecessarily delay patients’ access to needed care and create administrative burdens on providers when they vary significantly by plan.
FHA supports legislation to minimize clinically unnecessary prior authorization requirements, set forth strict timeframes for plans to issue authorizations, and to increase transparency of health plan processes.
