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Chris Mazzolini is the editorial director of Medical Economics
More than 370 physician groups have come out in support of legislation they say would simplify and streamline some prior authorizations
More than 370 physician associations wrote a letter to Congress urging members to support legislation that would simplify and streamline prior authorizations for Medicare Advantage patients.
The physician groups-which include groups that represent primary care physicians such as the American College of Physicians, the American Academy of Family Physicians, the American Osteopathic Association and more-are pushing Congress to support the Improving Seniors’ Timely Access to Care Act of 2019, which has been introduced by a bipartisan group of representatives.
“This bipartisan legislation would help protect patients from unnecessary delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program, providing much-needed oversight and transparency of health insurance for America’s seniors,” the letter reads. “We urge you to join your colleagues in supporting this important legislation.”
The bill has five key provisions. According to the letter, it would:
Streamlining prior authorizations for Medicare Advantage patients could be a major relief to physician practices and the health system. A 2019 Kaiser Family Foundation report shows that more seniors are choosing Medicare Advantage plans, and that nearly half of all Medicare patients (47 percent) will be using Medicare Advantage by 2029.
Prior authorization is one of the issues that physicians say is ruining medicine. They say it gives payers too much power to dictate treatment plans, snarls practice efficiency with extra administrative burdens and gets in the way of the physician-patient relationship.
In surveys, physicians tell Medical Economics that prior authorization is one of the most challenging issues they deal with each year, and one of the leading causes of physician burnout.
The letter coincides with a Congressional hearing on prior authorization, in which four physicians told the House Committee on Small Business how prior authorizations get in the way of patient care.
“While there may be a limited number of justifiable cases where prior authorization is appropriate,” said John Cullen, MD, AAFP’s president, “it is clear that health plans more often require prior authorization as a cost containment strategy by limiting and restricting access to specific services.”