‘Provider burden’ bill pits health care providers against insurance companies

VTDigger

Health care providers have rallied behind legislation that would limit how insurers could respond to orders and claims submitted by clinicians. But insurance companies say the bill would significantly drive up the cost of premiums.  For weeks, health care providers have been telling lawmakers horror stories about dealing with insurance companies. 

At a press event last week, Kristen Connolly, a pediatrician at Timber Lane Pediatrics in Milton, told a story about treating a malnourished infant who needed a special formula. But the baby’s health insurer declined to approve that special formula, reversing course only after Connolly spent hours on the phone, writing letters and filling out paperwork.

Then there was Michael, a child who needed a medication for asthma that was not approved by his family’s insurer. Anne Morris, a physician at a University of Vermont Medical Center clinic, told lawmakers in the House Health Care committee in January that it took two months of phone calls and pharmacy visits from Michael’s mother and multiple letters from his doctor to get the medication approved. 

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