1. United States
2. Colo.
3. Letter

My name is Sierra Thomas, and I am a licensed clinical social worker and Colorado resident writing to urge your support for prior authorization (PA) reform — specifically for individuals living with chronic and terminal illnesses. I have epilepsy. Without anti-epileptic drugs, I will have seizures. Without seizure control, I could die. Yet in recent months, my insurance carrier (Cigna) rejected two medications my neurologist prescribed as part of my care plan. One would have cost me $2,000 for a 30-day supply out of pocket. Another, $640. These are not luxury treatments. These are seizure medications- my lifeline. Each denial meant delays. Each delay meant risk. And each appeal placed the burden squarely on my physician- who had already done his job by prescribing the appropriate treatment- to now fight an insurer for permission to provide effective management of his patient. I also work as the social worker in radiation oncology at St Joe’s Hospital in Denver, where I witness this crisis from the other side of the desk. Recently, I watched a patient with a glioblastoma — an aggressive, often fatal brain tumor — have her chemotherapy denied by her insurance company. Her treatment was delayed. With glioblastomas, days matter. Weeks can mean the difference between life and death, or a longer life expectancy. No person battling a terminal illness should have to wait for a bureaucrat to approve what her oncologist already determined she needed. Prior authorization, as currently practiced, is not a patient safety tool. It is a cost-containment mechanism driven by capitalism and greed, that too often overrides clinical judgment, delays critical care, and causes measurable harm. I am asking you to create and or support legislation that would: • Exempt certain diagnoses — including epilepsy, cancer, and other chronic and/or terminal conditions — from prior authorization requirements for prescribed treatments • Require expedited PA review (within 24–72 hours) for urgent and time-sensitive conditions • Establish a “gold carding” standard so that physicians with demonstrated appropriate prescribing patterns can bypass PA entirely • Limit insurer authority to override a treating physician’s clinical judgment without equivalent peer review Colorado residents deserve to access their medications without a fight. My doctor and his team should not need to spend hours on hold, submitting appeals, and justifying sound medical decisions to insurance reviewers who have never met me. I am asking you to stand with patients in this state- those managing seizures, those fighting cancer, those living every day in the balance between treatment and crisis. We cannot afford to wait. Thank you for your time and your service to Colorado. I welcome the opportunity to speak with you further about this issue.