Physicians Want Action to Fix Prior Authorization Delays

Feb 23, 2024 at 07:56 am by kbarrettalley

Alabama physicians say a new federal rule may help patients in government-sponsored health programs get more timely treatment, but action is needed at the state level that applies to private insurance plans. Under the new federal rule, health insurers that participate in Medicare Advantage, Medicaid and the Children’s Health Insurance Program would have to respond to prior authorization requests faster and include specific reasons for denying requests.

“Prior authorization is a bureaucratic mess and patients pay the price,” said Mobile physician George Koulianos, MD, who serves as President of the Medical Association of the State of Alabama. “Imagine forcing a patient with a severe illness to wait days or weeks for authorization from an insurance company to start treatment. Now imagine a doctor having to employ multiple back-office personnel just to manage that insurer-imposed burden. This new federal rule is a step forward, but we also need action at the state level.”

A survey by the Medical Association found that physicians are deeply concerned about prior authorization requirements delaying necessary care, with one-third of physicians and clinical staff spending nearly an entire workday each week on prior authorizations alone. Not surprisingly, 76 percent said the time spent on prior authorizations means they see fewer patients in a day, reducing access to care and further fueling burnout in the medical profession.

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March 2024

Mar 20, 2024 at 11:19 am by kbarrettalley

Your March 2024 Issue of Birmingham Medical News is Here!