Nav: Home

370 healthcare groups send letter to congress urging prior authorization reform in medicare advantage

September 11, 2019

WASHINGTON, DC - The American College of Rheumatology (ACR), along with 369 other leading patient, physician, and healthcare professional organizations, sent a letter to Congress urging passage of the Improving Seniors' Timely Access to Care Act of 2019 (H.R. 3107), a bipartisan bill to protect Medicare Advantage beneficiaries from prior authorization requirements that needlessly delay or deny access to medically necessary care.

Introduced by Representatives Suzan DelBene (D-WA), Mike Kelly (R-PA), Roger Marshall, MD (R-KS), and Ami Bera, MD (D-CA), the Improving Seniors' Timely Access to Care Act would make it easier for patients to access medically necessary treatments by requiring the Centers for Medicare & Medicaid Services (CMS) to regulate the use of prior authorization by Medicare Advantage plans. The bill would also increase transparency by mandating that health insurance plans report to CMS their prior authorization usage rate and the frequency with which they approve or deny coverage.

"While intended to control costs, the unregulated use of prior authorization has devolved into a time-consuming and obstructive process that often stalls or outright revokes patient access to medically necessary therapies," said Paula Marchetta, MD, MBA, president of the ACR. "Many healthcare plans now use prior authorization indiscriminately, ensnaring the treatment delivery process in webs of red tape and creating gratuitous hurdles for patients and providers. Patients, physician groups, hospital associations and other key stakeholders all agree that reform is needed."

According to a study conducted by the American Medical Association, over a quarter of doctors surveyed said prior authorization has led to a "serious adverse event" for patients, such as hospitalization and permanent bodily damage. The same study found that 91 percent of doctors say that prior authorization is associated with treatment delays.

As part of the Regulatory Relief Coalition - a group of national physician specialty organizations - the ACR has been a staunch advocate for reducing regulatory burdens in the Medicare program to assure patients have access to timely and medically necessary treatment.

The full letter is available here.
-end-
About the ACR

The American College of Rheumatology (ACR) is the nation's leading medical association for the rheumatology community and represents more than 7,700 U.S. rheumatologists and rheumatology health professionals. As an ethically driven, professional membership organization, the ACR is committed to improving healthcare for Americans living with rheumatic diseases and advocates for policies and reforms that will ensure safe, effective, affordable and accessible rheumatology care.

American College of Rheumatology

Related Physician Articles:

Physician heal thyself: Simple coping strategies for pervasive physician burnout
The proverb, 'physician heal thyself,' is probably more relevant today than it was in biblical times with the fast pace of life, the impact of multitasking and the unending bombardment of information, which have made emotional exhaustion almost certain.
Questions raised over physician-assisted suicide
Few issues in medicine have been more controversial in recent years than physician-assisted suicide, with medical experts and the general public unable to come to a consensus that balances the delicate issue of dying with dignity with the interests of the individual and society as a whole.
Physician moms are often subject to workplace discrimination
Of the nearly 6,000 physician mothers in the survey, nearly 78 percent reported discrimination of any type.
Study finds significant limitations of physician-rating websites
An analysis of 28 commercial physician-rating websites finds that search mechanisms are cumbersome, and reviews scarce, according to a study appearing in the Feb.
Computer work dominates physician workday
Internal medicine physicians at a Swiss teaching hospital frequently worked overtime and spent about three times as much time using a computer as they did on patients.
More Physician News and Physician Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Anthropomorphic
Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#534 Bacteria are Coming for Your OJ
What makes breakfast, breakfast? Well, according to every movie and TV show we've ever seen, a big glass of orange juice is basically required. But our morning grapefruit might be in danger. Why? Citrus greening, a bacteria carried by a bug, has infected 90% of the citrus groves in Florida. It's coming for your OJ. We'll talk with University of Maryland plant virologist Anne Simon about ways to stop the citrus killer, and with science writer and journalist Maryn McKenna about why throwing antibiotics at the problem is probably not the solution. Related links: A Review of the Citrus Greening...