Resources and News

Dr. William Kilgo, a neurologist, aids patients with multiple sclerosis, impacting vision, balance and mobility. His main challenge in delivering timely care is the prior authorization requirements from insurance companies.

Pediatricians, even those delivering emergency care, are not immune to the woes that prior authorization creates for patients and the physicians caring for them.

Melissa Garretson, MD, discusses how to talk to patients about prior authorization, why prior authorization takes so long, and how the AMA is fighting to fix prior authorization policy. AMA Chief Experience Officer Todd Unger hosts.

Medicare Advantage plans have increased their use of prior authorization and appear to be targeting certain types of care -- such as expensive post-acute hospital care -- for coverage denials.

A Michigan law requires coverage of cancer drugs. One insurer came up with a “defensible” way to avoid paying for treatments that offered Forrest VanPatten his last chance for survival. “We crossed the line,” says a former executive.

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Zoey's care team explained to the family that without urgent treatment, the tumor would grow, and the cancer could spread.

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A 21-year-old with a rare cancer had to wait for prior authorization approval for proton therapy, and as a result, she faced several complications, needing a tracheostomy and feeding tube. 

Prior authorization significantly contributes to physician burnout. Dr. Marilyn Heine, an AMA Board member and Drexel University professor, discusses its impact, the growing physician shortage, and shares her experiences with AMA's Todd Unger.

Prior authorization buries doctors in paperwork and delays care, sometimes with disastrous results.

Insurers’ denial rates — a critical measure of how reliably they pay for customers’ care — remain mostly secret to the public. Federal and state regulators have done little to change that.