Health insurers and benefit managers are increasingly requiring health care professionals to obtain prior authorization before providing pharmaceuticals and medical services.
These requirements can interrupt care, divert resources from patients and complicate medical decision-making.
The AMA is reducing the harmful impact of these utilization management programs through reform initiatives, research and practice resources.
Physician advocates can also promote meaningful changes to prior authorization and improve access to care by using the following resources.
Prior authorization model legislation
The AMA has created a model bill (PDF) and related issue brief (PDF) that medical societies can use to begin efforts to address prior authorization in state legislative processes.
Prior authorization state laws
See—at a glance—how the laws governing prior authorization (PDF) differ from state to state.
Grassroots advocacy campaign
The AMA launched a grassroots advocacy campaign on prior authorization reform housed on the website FixPriorAuth.org. This effort gathers patient and physician practice stories about prior authorization burdens and features them in an online story gallery. The FixPriorAuth campaign also includes a call to action.
For more information on advocacy to address administrative barriers, please contact Emily Carroll, senior legislative attorney at [email protected].