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  • ISMS-Backed Prior Authorization Reform Bill Introduced in General Assembly

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    The use of prior authorization has exploded in recent years as a cost-cutting measure by health plans – at the expense of patient care.

    Earlier this week, ISMS-backed bills designed to address bureaucratic delays caused by prior authorization were introduced in Springfield.

    This comprehensive bipartisan legislation, known as the Prior Authorization Reform Act, was introduced in the Illinois House of Representatives (House Bill 711) and the Illinois Senate (Senate Bill 177). 

    This legislation would establish deadlines for prior authorization decisions – 24 hours for urgent care services and 72 hours for nonurgent care – so patients would no longer have to worry about insurers’ decision-making delays causing further damage to their health.

    The Act would also ensure that prior authorization requirements are based on medical evidence and that decisions are administered by qualified professionals.

    “Before COVID-19, more than a thousand Illinois physicians responded to an ISMS survey and the vast majority expressed frustration about the harms caused to patients by this cumbersome prior authorization system,” said ISMS President Robert W. Panton, MD.

    The Your Care Can’t Wait Coalition, an ISMS-lead group of healthcare and patient advocacy organizations, formed to support the Prior Authorization Reform Act. Our message to Illinois patients is simple: Your care can’t wait!

    Learn more at www.YourCareCantWait.org

    If you have questions, please contact ISMS Senior Vice President of Legislative Affairs Erin O'Brien by email

  • A Maddening and Inescapable Obstacle – It’s Called Prior Authorization
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    Cardiac patients wait days to receive treatment. Oncology patients wait weeks to start chemotherapy. Psychiatry patients must stop effective brand-name treatments in order to try less expensive generic alternatives. What type of system creates such havoc across the medical spectrum? Virtually every practicing physician in the state knows the answer, and can relate similar stories of harmful delays, denials and other intrusions on the practice of medicine, all brought about by prior authorization.

    Read more …

  • Did You Provide COVID-19 Testing Services to Uninsured Patients?
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    The Illinois Department of Healthcare and Family Services (HFS) launched the HFS COVID Portal, designed to receive and process claims for COVID-19 testing services for uninsured individuals, regardless of their income, citizenship or immigration status. 

    This portal is now ready to accept claims with dates of service going back to March 18, 2020.  

    Healthcare professionals are reminded to first check the  Medical Electronic Data Interchange (MEDI) to determine whether a patient has active Medicaid coverage or managed care organization (MCO) enrollment before requesting a registrant identification number (RIN) and submitting claims through this portal.  

    COVID-19 tests for patients who already have Medicaid coverage should be billed through regular channels. 

    Read HFS’ February 8 Provider Notice.

    If you have questions, please contact the ISMS Health Policy Research and Advocacy team by email.  

  • Register Now for These Live Webinars – at No Cost!

    Implicit Bias in the Mirror and Through the Glass: Navigating Implicit Bias Personally & Professionally

    February 18 | Noon to 1 p.m.

    Join ISMS’ new webinar covering why the concept of implicit bias is relevant to the practice of medicine, and how physicians can begin to uncover and challenge their unconscious perceptions. The Program will also include a discussion providing examples of how physicians can find personal and professional satisfaction while learning to reframe their interactions with their patients.

    • ISMS members, ISMIE policyholders and their staffs can participate at no cost.
    • CME offered | Register here

    Medication Safety Considerations During the COVID-19 Pandemic

    March 16 | Noon to 1 p.m.

    In the midst of the pandemic, information related to medications used for COVID-19 treatment is rapidly changing. This could pose significant risks, including adverse drug interactions and polypharmacy, for physicians and patients when adding COVID-19 treatments to a patient’s medication regimen.

    Minimizing this risk is of utmost importance in providing safe patient care.

    Join ISMIE Mutual’s* webinar to address this risk, covering risk management strategies for COVID-19 treatments and supportive/alternative therapies, along with the latest guidance and common adverse effects.

    • ISMS members, ISMIE policyholders and their staffs can participate at no cost.
    • CME offered | Register here.

      *ISMIE Mutual is ISMS’ endorsed carrier.

  • Take Advantage of Significant Savings on Supplies and Services!
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    Buy in bulk with other doctors

    With your budget negatively impacted by the COVID-19 crisis, check out CCPA Purchasing Partners– a doctors-only buying group. 

    Through group negotiations, significant savings and favorable payment terms are available with vaccine manufacturers, medical and office suppliers, and medical waste disposal services.

    ISMS members can join with: 

    • No minimum purchase requirements with vendors or vaccine companies in order to receive upfront discounted pricing.

    • No monthly or annual dues.

      CCPA Purchasing Partners is an ISMS Benefit Partner.

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