A WOMAN has been forced to live without important medicine for months that allows her to work every day after her insurance allegedly denied her access to the drug. 

Now, the state of New Jersey is taking action to help residents get easier access to necessary medications. 

Sandra Johnson, who lives in the Garden State, was diagnosed with severe persistent asthma a few years ago, limiting her daily activities. 

“Getting up to walk from my bedroom to the bathroom, I will be so out of breath that I would have to just sit on the toilet with the seat down … to prepare myself to get up to take a shower,” Johnson told WHYY News. 

She claimed that at the time she was diagnosed, her doctor prescribed an injectable drug to treat the asthma. 

However, before she could start taking the medication, her doctor needed to receive prior authorization from Johnson’s insurance company. 

Johnson claimed this process took some time, saying her doctor went back and forth with the insurance provider to prove that she needed the medication.  

Ultimately, the company reportedly provided approval and Johnson was able to start treatment. 

She told WHYY News that with the medication, she was able to return to work and her other daily activities. 

That was until her insurance allegedly requested prior authorization as well for the same treatment. 

Despite it being previously approved, Johnson claimed her provider denied the medication, leaving her without treatment. 

“I don’t have an understanding of why it’s being denied when this medication that I have been taking has been working for me, allowing me to have a better quality of life and being able to function on an everyday basis,” Johnson told the outlet. 

Johnson did not reveal what insurance provider she had been using,

Tina Shah, a pulmonary and critical care doctor based in New Jersey, told WHYY News that issues over prior authorization from insurance companies often disrupt the care she is able to give her patients. 

“This causes so much moral distress that I often go home, and I have to decompress because I know that I can be the best doctor, but because of prior authorizations I often can’t deliver the best care,” Shah said. 

In an effort to help ease access to important and emergency medications, New Jersey Gov. Greg Murphy signed a law in January to speed up the traditional timeline that prior authorizations often take. 

The new legislation will enforce regulations on prior authorizations, requiring any urgent requests to be processed by insurance providers within 72 hours. 

Patients receiving hospital and emergency care must have requests processed within 24 hours.

Standard requests must be processed within seven calendar days. 

Additionally, if a request is made that requires “immediate post-evaluation or post-stabilization services” the prior authorization must be decided within 60 minutes. 

If the authorization determination is not made within that time frame, the law states that the services will be “deemed approved.” 

In the case that the prior authorization is denied, the new law orders that it must be addressed by a doctor within the same specialty of the treating physician that requested the authorization. 

All denials must be published by the insurance providers and be “readily accessible on its Internet website to subscribers, health care providers, and the general public.”

The law goes into effect on January 1, 2025.

Shah celebrated the new legislation saying she believes it will have a large effect on the healthcare industry. 

“I actually have hope that I’m not just a widget in the healthcare industry,” she told WHYY News. 

“When this bill goes into effect in January 2025, we’re going to feel it,” she said. “It’s going to … allow me to do what I actually trained to do — spend time with my patients and try and make them feel better.”