Medscape May 26, 2022
Last December, a young patient was admitted to Nationwide Children’s Hospital in Columbus, Ohio, after several medications had failed to quell the child’s relentless seizures. A hospital pediatrician, Vignesh Doraiswamy, consulted with neurologists and then tried a different drug. The child had fewer seizures, became more interactive, and was ready to go back home, says Doraiswamy. But there was a problem: The patient’s insurance company refused to authorize the new medication for the parents to administer. The family had to remain in the hospital for at least two more days, Doraiswamy recalls, while the decision went through an appeals process.
Doctors have long asserted that prior authorization — the need to get approval from the patient’s insurer before proceeding with...
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