In the near future, we will introduce legislation to reduce delays in access to mental health medications by requiring health insurers to follow a clear process that ensures Pennsylvanians with mental illness can receive timely and meaningful treatment.

In 2022, the General Assembly improved a patient’s ability to access critical health care services through the passage of Act 146 of 2022, which reformed the health insurance prior authorization and step therapy processes.  This legislation critically improved transparency, accessibility and consistent application of prior authorization by standardizing definitions. 

Act 146 also streamlined the process by requiring insurers to make available an electronic communications network that permits prior authorization requests to be submitted electronically, and authorizations and adverse determinations to likewise be returned electronically.  

However, an unintended consequence of Act 146 is that, even with these improvements, access to pharmacological treatments for mental health illnesses is still too often delayed or denied to those Pennsylvanians who need treatment in a timely manner.  The continued practice of using prior authorization and step therapy processes by health insurers, as it relates to mental health pharmacological treatments, forces patients to fail on a particular treatment before gaining access to an effective treatment which will meaningfully manage their condition. 

The delays in treatment caused by the “fail first” protocols relied upon by insurers only worsen the suffering of the patient with the mental health illness, potentially jeopardizing the safety of both the patient and those around him or her. 

Our legislation will address this concern of delaying access to mental health pharmacological treatments by creating a process to be followed by health insurers which eliminates delays and ensures meaningful access to care for those Pennsylvanians suffering from mental illness, meaningful access to pharmacological treatments which ensures that those Pennsylvanians suffering from mental illness can timely address their illness, while minimizing any concern for safety to themselves or others.

The concern about ensuring access to mental health treatment, specifically pharmacological treatment, is not inconsequential.  According to the National Alliance on Mental Illness, in 2021, over 1.8 million adults in Pennsylvania suffer from a mental health condition, and over 440,000 of these adults suffer from a mental health condition that was medically classified as a serious mental illness.

We respectfully ask that you join us in cosponsoring this bill to better help all Pennsylvanians suffering from mental illness.