Patients, advocates and researchers welcome regulations but argue rules don’t go nearly far enough to tackle scale of problem

A new set of rules from the Biden administration seeks to rein in private health insurance companies’ use of prior authorization – a byzantine practice that requires people to seek insurance company permission before obtaining medication or having a procedure.

The cost-containment strategy often delays care and forces patients, or their doctors, to navigate opaque and labyrinthine appeals.

The administration’s newly finalized rules will require insurance companies who work in federal programs to speed up the approval process and make decisions within 72 hours for urgent requests. The regulations will also require companies to give a specific reason as to why a request was denied and publicly report denial metrics. The regulations will primarily go into effect in 2026.

  • maynarkh@feddit.nl
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    9 months ago

    Okay, stupid question, as an European I don’t know if that’s the case with our insurance. Sure there may be waiting times for organ donors or whatnot, but healthcare is not going to put me into debt. I’ve had one in a million illnesses in my family where one has to stay at a hospital for months before and after a complex surgery, but it never has been a money issue.

    • bluGill@kbin.social
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      9 months ago

      Most beople have health insurance here and don’t go into debt. it is a minority that run into problems.

      you may not be allowed some expensive care, but your doctor won’t tell you it is an option elsewhere as you can’t get it. If you have such a condition you could go to a different country for care, but odds are you don’t as such things are rare.