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, set.
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During a declared state of emergency, hospitals need to deliver care quickly without unnecessary administrative barriers. FHA supports legislation requiring health plans to waive authorizations or precertification requirements during a declared state of emergency to streamline and expedite care.
Since 1992, the federal 340B drug pricing program has helped providers treating high numbers of uninsured and low-income patients purchase certain outpatient drugs at discounted prices and use those savings to “stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.”
Hospitals must meet federally established eligibility criteria to qualify for the prescription drug discounts. Generally, this means the hospital: is government controlled or has a contract with the government to treat patients that are not entitled to Medicare or Medicaid benefits; has a sufficient Medicare disproportionate share hospital (DSH) adjustment percentage; and (for certain hospitals) does not obtain drugs through group purchasing arrangements. There are 42 Florida hospitals participating in the 340B program.