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.
Resource | AMA
Explore the answers to frequently asked questions that you and your loved ones may have about the prior authorization process.
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 | 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
This report by the Advisory Council on Employee Welfare and Pension Benefit Plans (ERISA Advisory Council) examines issues concerning group health plan claims and appeals processes, especially focused on employer-sponsored health benefits.
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.
Resource | AMA
Prior authorization is overused and causes significant administrative burdens. To reduce prior authorization’s harmful impact, the AMA conducted significant research to reveal physician concerns over the real-life issues caused by this system.
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.
News | AMA
This AMA Update covers the flawed prior authorization process and discusses who is responsible for completing the process, how pharmacists can help physicians and what technicians can do to help expedite approvals.
News | AMA
Physicians must show legislators how prior authorization harms patients. Then they need to tell them again—with the data to back it up.
News | KFF Health News
Colleen Henderson’s 3-year-old daughter was diagnosed with a grapefruit-sized tumor in her bladder. Yet, for five years, Henderson battled with her insurer over paying for the specialists who finally diagnosed and treated her daughter’s rare condition.
News | HME Business
Medicare Advantage prior authorization presents several challenges for home medical equipment (HME) companies, primarily due to administrative burdens, delayed care and financial strain.
News | NBC Chicago
When Jessica was diagnosed with Stage 4 cancer, her doctors prescribed both immunotherapy and chemotherapy – but her insurance company denied the prior authorization. After an appeal, dozens of phones calls and cries for help, Jessica’s once denied request was approved.