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.
Physician advocates can also promote meaningful changes to prior authorization and improve access to care by using the following resources.
The AMA has created a model bill (PDF) that medical societies can use to begin efforts to address prior authorization in state legislative processes.
See—at a glance—how the laws governing prior authorization (PDF) differ from state to state.
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 by way of a petition and Congressional sign-on letter, as well as an associated social media effort.
For more information on advocacy to address administrative barriers, please contact Emily Carroll, senior legislative attorney at [email protected].