Pringle law to remove barriers to patient care goes into effect

AUGUSTA – A bill sponsored by State Rep. Jane Pringle, D-Windham, that will work to ease the administrative burden on healthcare providers has gone into effect.

State Representative Jane Pringle 

Pringle’s bill, LD 796 was signed into law by Maine Gov. Janet Mills and directs the Maine Bureau of Insurance to gather data from insurers on the approval and denial rates of prior authorization requests, as well as the outcomes of any appeals to those decisions. 

This data, covering 2021 to 2023, will be compiled and reported to the Maine Legislature’s Health Coverage, Insurance and Financial Services Committee in early January 2025.

In a medical setting, prior authorization refers to the process where a healthcare provider contacts a patient’s insurance company to inquire whether the prescribed treatment will be covered under the patient’s policy. If the request for authorization is denied, it can result in a significant administrative burden and delay or disrupt care.

“It is imperative that doctors are able to deliver medically appropriate treatment to patients without unnecessary administrative delay,” said Pringle. “This bill will ease the administrative burden that has been created by prior authorization by helping to hold insurance companies accountable for the percentage of claims that are denied, upheld and overturned. When doctors are allowed to deliver treatment without the impediment of an administrative bureaucracy, the cost of care drops while patient satisfaction and health outcomes improve.”

Pringle is serving her second, non-consecutive term in the Maine House representing part of Windham and is a member of the Joint Standing Committee on Health Coverage, Insurance and Financial Services. <