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Committee gives do-pass to bill restricting prior authorization for certain treatments; opponents warn of cost and safety risks
Summary
The House Health and Human Services Committee voted 6-0 to recommend House Bill 570, a measure that would limit prior authorization requirements for certain health services after testimony that prior authorization sometimes delays urgent care such as chemotherapy.
The House Health and Human Services Committee voted 6-0 to give House Bill 570 a do-pass recommendation after hearing competing testimony about prior-authorization requirements.
Supporters, including medical oncologist Barbara McEnany, told the committee that prior authorization can delay necessary chemotherapy and other time-sensitive treatments; McEnany said prior authorization sometimes made patients wait weeks for cancer care and that existing approvals are near-universal but delays harm patients.
Opponents including the Pharmaceutical Care Management Association (PBM representative Jonathan Buxton), the health-plan trade group America's Health Insurance Plans (registered lobbyist Brent Moore) and Blue Cross Blue Shield of New Mexico argued that prior authorization is a necessary tool to ensure clinical appropriateness and control costs. Opponents said prior authorization helps confirm evidence-based care and prevents overuse; they also pointed to administrative and fiscal impacts raised in the fiscal-impact report.
A patient advocate raised concerns that broadly eliminating prior authorization could drive insurers from the state or remove safeguards for complex conditions. Committee members discussed whether some categories already were exempted (witnesses said prior authorization for cancer drugs/treatments has been removed in some existing rules) and whether narrower carve-outs or improved turnaround requirements might address delays.
A motion for a do-pass recommendation was moved and seconded; the committee recorded a 6-0 vote in favor and the bill will proceed with the committee's recommendation.
