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Gov. Reeves concerned prior authorization bill will up premiums for state employees

Mississippi Governor Tate Reeves
Gov. Tate Reeves (Photo by SuperTalk Mississippi News)

A bill to reform Mississippi’s prior authorization process will go into law without the signature of Gov. Tate Reeves.

The Republican governor made a lengthy social media post on Thursday afternoon, explaining why he chose not to put pen to paper on Senate Bill 2140. While Reeves wrote that he doesn’t disagree with the basis of the bill – to speed up the process of health insurance companies deciding whether or not to approve a prescribed procedure, service, or medication – he has concerns over its inclusion of the Mississippi State School Employees’ Life and Health Insurance Plan.

Often referred to as the State Plan, the government-provided insurance covers nearly 190,000 residents and their families and is primarily funded through premiums paid by those insured under the plan. Reeves is worried that SB 2140 could ultimately result in premium increases for those employed by the state.

“…every dollar in increased administrative and benefits costs imposed on the State Plan as a result of Senate Bill 2140 will be passed on to state employees and their families through premium increases,” a portion of the post on X reads. “While the price of a medical procedure generally remains stable over a period of 60 to 180 days, the price of pharmaceuticals can fluctuate wildly during that same period. Senate Bill 2140 limits the ability of the State Plan to quickly adjust the pharmaceuticals covered under the State Plan.”

“This means that the State Plan will be required to provide coverage for more costly drugs despite the fact that cheaper equivalent drugs may come to market or become available. Senate Bill 2140 also requires the State Plan to continue to provide coverage for pharmaceuticals taken by new state employees for a period of at least 90 days after beginning their employment with the state. This is despite the fact that such pharmaceuticals may not be covered under the State Plan and cheaper alternative equivalents are available.”

Reeves added that based on data from his office, if SB 2140 increases the overall cost of the State Plan by $30 million annually, those covered will see a premium increase of $158 per year. If the cost increases by $100 million annually, premiums would be upped by an additional $526 per year.

“I am allowing Senate Bill 2140 to become law because I agree that it is a significant improvement over its predecessor and that reform of the prior authorization process is much needed,” Reeves continued. “That being said, I cannot put my signature on this bill because of its potential effects on the premiums paid by state employees.”

Reeves did offer a couple of suggestions to lawmakers to address his main concern, including removing the State Plan entirely from the bill’s scope or committing to an annual appropriation to cover the increased costs he projects as a result of the legislation.

State Plan aside, Senate Bill 2140 would require insurers to respond to emergent requests within 48 hours and non-emergent requests within seven working days. It would also require the process to go through an online web portal in which physicians can request prior authorization and appeal denied applications. The portal would be under the umbrella of the Mississippi Department of Insurance, which is expected to receive appropriation for two new hires with the bill going into law.

It’s unclear at this time if lawmakers will consider addressing Reeves’ concerns before the bill goes into effect on July 1, 2024.

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