Lawmakers study prior OK on drugs
By Brandon Larrabee| Morris News Service
Friday, September 05, 2008

ATLANTA --- Insurance companies could be forced to curtail their practice of requiring doctors to get permission before prescribing certain drugs, the chairman of a legislative panel examining the issue said Thursday.

Insurance providers say the practice, known as "prior approval," helps them cut back on prescription drug costs. But lawmakers such as Sen. Jack Murphy, R-Cumming, said the requirement for permission inconveniences consumers and physicians. Mr. Murphy said he's heard complaints from doctors that they are facing more "prior approval" notices.

"They're getting inundated by these, which is taking away from their time for the patients," Mr. Murphy said.

The committee is also likely to look at making insurance companies share the liability for complications from prescriptions that were changed because of prior approval and new regulations for private companies that manage pharmacy benefits.

But completely barring the process could increase costs on insurers, including the plan for state employees. The Department of Community Health estimates it saves at least $20 million a year from doctors who give patients a different, lower-cost drug after getting a prior approval notice.

Under prior approval, an insurance company will tell a pharmacist whether a drug is on a list of approved medications for a patient. If it isn't, the pharmacy then contacts the doctor, who can either change the prescription or tell the insurance company why the drug is needed.

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