The AMA recently sponsored an event in which 500 physicians and medical society executives attending the AMA National Advocacy Conference in Washington visited their legislators and told them that patients are harmed by prior authorization (PA), an insurance company cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage. “The prior authorization process became indefensible years ago,” Seema Verma, administrator for the Centers for Medicare & Medicaid Services (CMS), said during a speech at the conference. “Patients are frustrated, and doctors are sick of pointlessly wrangling with insurance companies.” Verma also noted, “Prior-authorization requirements are a primary driver of physician burnout,” she said. “And, even more importantly, patients are experiencing needless delays in care that are negatively impacting the quality of care.”
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