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Over my years in the Minnesota Senate, I had rarely found myself working on health and human services policy.
In winter 2023, I was diagnosed with ovarian cancer. This diagnosis launched me into a profound journey through the intricacies of health care, medical access and insurance coverage. I had just been elected Senate majority leader, and when I expressed to my doctor that the timing was terrible, she responded, “There is never a good time for cancer.”
Like many people diagnosed with cancer, I continued my work at the Senate while balancing countless appointments for blood work, MRIs and CT scans, surgery, chemotherapy and radiation.
Ovarian cancer treatment varies if the cancer is hereditary, so I was advised to undergo genetic testing. Despite receiving preauthorization, I was shocked when I received a $6,000 bill. Upon reviewing my insurance plan, I discovered that DNA and genetic testing are covered if deemed medically necessary for treatment determination. Fortunately, I had the capacity to interpret the details of my plan and appeal the charges.
Later, I received another staggering bill for $100,000 and learned that the first chemotherapy treatment was covered, but the next two were not due to a lack of preauthorization. This led to a convoluted process, where I, as the patient, coordinated between my care providers to appeal and correct the oversight.
During the 2024 legislative session, we started making changes to the prior authorization rules to standardize timeline reviews, expedition, appeals and continuity of care. We also ensured prior authorization for chronic conditions remains valid unless there are changes in treatment standards. This is a first step forward to advance the conversation on prior authorization requirements.