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
Prior authorization has shifted from a rare tool to a routine cost-control process for insurance companies, often delaying care and wasting time, becoming second nature to payers in managing health care utilization.
News | Fierce Healthcare
The American Medical Association (AMA) and a bipartisan group of Congressional leaders are looking to stop unfair prior authorization practices from health plans.
News | AMA
With the American Medical Association’s support, bipartisan legislation was introduced in the House and Senate to streamline and standardize prior authorization in Medicare Advantage, following widespread backing in the last Congress.
News | MedCityNews
Hospitals are struggling with burdensome policies from insurers, affecting cash flow and patient safety. Executives urge federal regulators to enforce stricter rules for faster timelines and greater transparency in claims denial reasons.
News | AL.com
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.
News | AMA
Pediatricians, even those delivering emergency care, are not immune to the woes that prior authorization creates for patients and the physicians caring for them.
News | AMA
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.
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.