Physicians advocate in Michigan for prior authorization reform

From the AMA: For Entire Post, Go Here…

Earlier this year, hundreds of Michigan patients, their advocates, and their physicians packed multiple legislative committee hearings to share their experiences with insurance company prior authorization regulations. New survey data released by the American Medical Association (AMA) bolsters what they testified to lawmakers —burdensome prior authorization red tape is adversely affecting patient outcomes.

According to the survey, 91% of physicians say prior authorization leads to delays in care and 16% report the delay in care has led to a patient’s hospitalization. Despite a commitment by insurers two years ago to streamline prior authorization for patients, America’s physicians and their staff report in this poll that they still spend an average of two business days each week completing prior authorization forms and requirements and 86% of those surveyed say that the burden is increasing.

Prior authorization has long prevented patients from receiving the care they need from their physicians—causing treatment delays of days and weeks, or sometimes even months. In fact, 24% of the AMA’s survey respondents reported that a prior authorization has led to an adverse event for one of their patients. Moreover, today, as the nation faces the COVID-19 pandemic, prior authorization continues to interfere with access to care by forcing patients to make multiple trips to the pharmacy, delaying transfers out of hospital settings, and pulling valuable practice resources away from patient care when they need it most.

“Our patients are suffering because insurers, even during a pandemic, are choosing profits over patient care. This must stop,” said AMA President Susan R. Bailey, M.D. “Because insurers will not change their ways despite their rhetoric, policymakers have an important opportunity to rein in prior authorization requirements that adversely affect patient health.”

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