Becker's Healthcare January 27, 2025
Many physicians and practices say prior authorization is a major administrative burden and have urged lawmakers to institute reforms to the process for commercial and public payers.
Nearly 97% of providers have seen delays or denials for necessary patient care due to prior authorization requirements, according to the Medical Group Management Association’s 2023 “Regulatory Burden Report.”
Further, according to Medscape’s 2024 “‘They’re Awful and Impede Patient Care’: Medscape Physicians and Prior Authorizations Report 2024,” more than 7 in 10 physicians told Medscape that they believe the cost of prior authorizations are higher, or much higher, than they were three years ago.
Andrew Lovewell, CEO of Columbia (Mo.) Orthopaedic Group, described a “cyclical” pattern of repeated denials for treatment plans...
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