Let doctors make health decisions

We applaud Governor Pritzker’s commitment to tackle health insurance reform as outlined in his recent State of the State address. The governor has vowed to tighten up how payers conduct “utilization reviews” which is the process insurers use to determine whether a medical service will be covered under the health plan. The governor is also promising to prohibit step therapy, another impediment that patients must endure while the insurance companies decide whether to grant permission for treatments recommended by their physician. As the governor said, doctors and patients should be making decisions about medical care, not insurance companies.

It's time to hold these payers accountable. No more ghost networks that are misleading patients on available physicians within their insurance network and no more making patients and physicians jump through hoops so bureaucrats can make medical decisions or delay care.

It’s welcome news that these efforts that the physicians of the Illinois State Medical Society (ISMS) have been fighting for years now have the full backing of the governor’s office. Both the Prior Authorization Reform Act (2021) and the Network Adequacy and Transparency Act (2017) were ISMS-backed legislative initiatives to improve patient care and access to the physicians Illinoisans need and deserve in their communities.

We look forward to working with the governor and members of the Illinois General Assembly to make sure the people of Illinois have access to quality healthcare and that the administrative burdens on physicians are lessened so that more of their time can be spent on delivering patient care.

Rodney S. Alford, President

Illinois State Medical Society