Learn more about the ongoing effects of prior authorization on patients and physicians over the years. Explore relevant resources and news.
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To assess the ongoing impact the prior authorization process has on patients, physicians, employers and overall health care spending, the AMA annually conducts a nationwide survey of 1,000 practicing physicians from a wide range of practice settings.
News | Time
Erin Massey is a scientist at a biotech company, but recently, she’s had another practically full-time job: fighting with insurance. Erin shares her struggle with convincing her insurer to pay for her insomnia medication.
News | KFF Health News
Prior authorization has become a chronic pain point for patients and doctors. Both Republicans and Democrats agree that prior authorization needs fixing, but patients are growing impatient waiting for reform.
News | Medscape
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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.
Resource | AMA
Explore the answers to frequently asked questions that you and your loved ones may have about the prior authorization process.
Resource | AMA
Dive into how the flawed prior authorization system impacts the workplace by exploring the statistics, case studies and frequently asked questions included in this toolkit.
Resource | AMA
This chart outlines the legislative updates in each state.
News | AMA
Reducing the prior authorization burden that harms patients and frustrates physicians is an area of bipartisan agreement that Congress should tackle now.
News | AMA
Leaders at Geisinger wanted to reduce physician burnout so they tackled one of the biggest headaches in medical practice today: prior authorization. A pharmacy team now handles all requests, saving Geisinger clinics up to fours a week and boosting payer approval rates by 30%.
News | Axios
Optum Rx — which includes the pharmacy benefit manager of health care conglomerate UnitedHealth Group — is dropping annual reauthorization requirements for 80 drugs, which will eliminate more than 10% of overall pharmacy prior authorizations.
News | MedPage Today
Prior authorization requirements for patients undergoing primary total hip arthroplasty did not reduce costs, but did delay procedures, according to a prospective, single-center study.
News | AMA
Over 60% of physicians say unregulated AI tools systematically deny patients coverage for necessary care. The AMA is fighting to fix prior authorization.
News | Targeted Oncology
Prior authorizations have become a significant barrier to timely cancer care. At Orlando Health Cancer Institute, a centralized prior authorization model is addressing this growing challenge head-on.
News | Becker’s Payer Issues
In a March 1 notice to providers, UnitedHealthcare said it will eliminate prior authorizations for home health services that apply to Medicare Advantage and dual special needs plans in more than 30 states.
News | WTHR
First responders acted quickly to save Amanda Boley’s life using an air ambulance to transport her to the closest hospital. But Boley’s insurance said she should’ve obtained prior authorization for her emergency helicopter transport, even though she was unconscious, with no pulse. She had to fight for life and insurance coverage.
News | The Guardian
Social media outreach is not the conventional avenue through which to challenge health insurance-related delays and denials, but it can be effective. Miranda Yaver shares her story and struggle with insurers deeming her treatment “medically unnecessary.”
News | Healthcare Dive
Physicians surveyed by the AMA say that prior authorization can cause care delays or force patients to abandon treatment. They warn denials could increase as insurers adopt AI to review claims.
News | AMA
Many physicians fear the health insurance industry’s use of unregulated artificial intelligence automation and predictive technologies will increasingly override good medical judgment and systematically deny patients coverage for necessary medical care.
News | Physician Leadership
The current prior authorization process creates barriers to necessary medical treatment, causing frustration and potential harm to patients. Christopher Marks shares his struggle with insurers to get Mounjaro – the medication he needs for his Type 2 diabetes.