Industry News

Problems with Pre-Authorization

The AMA continues its efforts to reform the onerous prior-authorization process as a focal point to removing obstacles that interfere with patient care. In early September, the House of Representatives passed the “Improving Seniors’ Access to Timely Care Act of 2022”, and is hopeful the Senate will follow suit. Among the Acts’ requirements, Medicare Advantage plans must implement electronic prior auth programs, establish real-time approval for many items and services, and transparently publish just how often they require PA and how frequently they deny them. In a 2021 AMA survey, 93% of physicians said that prior authorization had delayed access to care their patients needed – and, 82% said the process had led patients to abandon treatment.