New bill being debated in California could lead to surgery shake-up
SACRAMENTO – Doctors routinely complain they have to get permission from insurance companies to treat their patients. Now a new bill being debated at the California State Capitol could change that.
"I had to learn how to do everything all over again," said Ocean McIntyre.
McIntyre says she has permanent eye damage after her health insurance denied her doctor's urgent medical treatment request.
"And in my case, it crushed the optic nerves from the inside," McIntyre said.
Last month, she told her story to state lawmakers.
"Being repeatedly denied care made me feel like I wasn't important," McIntyre said.
She's now supporting a new bill that would make it easier for doctors to treat patients without getting pre-approval from health insurance companies.
Dr. Amy Gaultney treats pediatric patients who often need specialized care.
"I spend a lot of time doing prior authorizations," Gaultney said. "The frustrating thing is that our patients can continue to suffer because their conditions aren't being adequately treated – and in the worst case, it really could result in a patient's serious disability or death."
If approved, the bill would allow physicians with a proven record of appropriate treatments to care for patients without pre-authorization.
"It means it exempts those people from having to jump through all these hoops [and] paperwork and phone calls that can delay care," said Gaultney.
But the bill is opposed by insurance companies and health plans who say the current system prevents waste, fraud, and inappropriate treatments.
"We are concerned that this measure in its current form will not only increase the cost of healthcare but more importantly will lead to poor patient outcomes," said Steffanie Watkins from the Association of California Life and Health Insurance Companies.
McIntyre says the current system emphasizes cutting costs over patient care.
"I don't want anybody else to go through the experience that I went through, or lose someone that they love unnecessarily," McIntyre said.
The bill by California State Sen. Nancy Skinner has been passed in the Senate and will need to be approved by the Assembly before heading to the governor's desk.