Learn more about the ongoing effects of prior authorization on patients and physicians over the years. Explore relevant resources and news.
Resource | AMA
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 | MedPage Today
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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.
News | ProPublica
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.
News | MedPage Today
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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.
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.
News | AMA
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.
News | New York Magazine
Prior authorization buries doctors in paperwork and delays care, sometimes with disastrous results.
News | ProPublica
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.
News | Federation of American Hospitals
Prior authorization related to Medicare Advantage Plans is becoming a major stumbling block in patient care.
News | ProPublica
After a college student finally found a treatment that worked, the insurance giant decided it wouldn’t pay for the costly drugs. His fight to get coverage exposed the insurer’s hidden procedures for rejecting claims.
News | ProPublica
Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files.
News | The Washington Post
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Many patients seeking better drug treatments are being rejected by their insurance companies.
News | Kaiser Family Foundation
While prior authorization has long been used as a tool to contain spending and prevent people from receiving unnecessary or low-value services, there are some concerns that current prior authorization requirements and processes may create barriers and delays to receiving necessary care, as well as exacerbate complexity for patients and their providers.