American Hospital Association June 21, 2024
For too long and for too many patients, the process of obtaining prior authorization for a medical procedure or medicine has been a tangled web, as people are forced to navigate complex, confusing and burdensome regulations from some commercial insurers that have resulted in the delay or denial of needed care.
Slightly more than half of America’s eligible Medicare population — more than 33 million people — are enrolled in Medicare Advantage (MA) plans, and they are more likely than those in traditional Medicare to report delays in care due to needed insurance approvals. The misuse or misapplication of prior authorization requirements has led to dangerous delays in treatment, clinician burnout and waste in the health care system.
The process...
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