HMA president calls for voluntary moratorium of controversial pre-authorization policy from HMSA

Hawaii Medical Association president calls for voluntary moratorium of controversial pre-authorization policy from HMSA

HONOLULU (HawaiiNewsNow) - In light of today's Star Advertiser's story titled "HMSA pre-authorization policy delaying critical tests, some doctors say" Dr. Scott McCaffrey, President of the Hawaii Medical Association (HMA) called today on Hawaii Medical Service Association (HMSA) to initiate a self-imposed moratorium on its controversial imaging pre-authorization program to examine other local alternatives that do not risk the well-being of patients. "Here in Hawaii, patients' lives are apparently being exposed to unnecessary risks because of this new HMSA policy.  The program functionally slows the diagnosis and treatment of patients when moments matter." McCaffrey explained.

HMSA relies on advice from mainland company National Imaging Associates (NIA) to establish pre-authorization standards for imaging studies, such as CT scans and MRIs, in which an insurance company scrutinizes the necessity of testing for a given patient prior to giving the approval for the test to be conducted.

From the Star Advertiser story, McCaffrey pointed out that physicians' opinions must be taken seriously to protect the interest of the patient. "Dr. Calvin Wong is a respected cardiologist with decades of experience and his concerns in the story are the concerns of the medical community.  Many other certified, seasoned clinicians have reported similar delays and difficulties in patient care".

McCaffrey reiterated his concern for patient safety surrounding a bill being heard in the Legislature House Bill 2740. "In medicine moments matter. The HMA does not object to evaluating a test as appropriate," stated Dr. McCaffrey, "but we are concerned that extensive levels of scrutiny can delay a patient's care, sometimes days to weeks, causing unintended health consequences.  HMA stands ready to assist in resolving this matter and has assembled a Blue Ribbon Task Force of physician leaders from its component specialty societies in the fields of  neurology, neurosurgery, orthopedics, cardiology and ob-gyn to assist in this effort.  Our Blue Ribbon committee members are some of Hawaii's finest and most experience physicians and have been tasked with developing workable solutions to fit Hawaii's unique healthcare environment."

Medical groups across the state are supporting HB2740 in an effort to protect their patients from unreasonable delays in care. The bill is currently being heard by a joint House/Senate committee chaired by Rep. Della Belatti and Sen. Rosalyn Baker.

McCaffrey called on HMSA to step up to the plate and sit with HMA leadership to consider local alternatives which emphasize both compassion and efficiency in healthcare delivery. "I am confident that, working in the Spirit of Aloha, we can find cost-effective alternatives to this challenge that do not put the patient at risk nor interfere with the efficiency of Hawaii's medical provider workforce."

HMSA provided the following statement:

We put safeguards in place to make sure every patient is protected from delay. Approval is automatic and immediate for any test that a physician deems is urgent, whether the request comes from in a hospital, an emergency room, or a doctor's office.  Even when there's no urgent need, the average time between submission of the needed clinical information and the determination of approval is only 24 hours.

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