Who Needs Prior Authorization Reform?

Written by Executive Vice President, Public Policy and Association Affairs, Andy Sandusky

February 21, 2020

After speaking with many DOs at the POMA District 8 meeting earlier this month, there was a constant refrain when the issue of prior authorization reform came up for discussion.  Which is, both patients AND physicians need prior authorization reform. 

DOs have shared with POMA multiple frustrations they are experiencing on behalf of their patients with failed first (and second) policies, as well as knowing the correct “key words” an insurer is looking for that will get the approval for what a patient needs.  Further, DOs often take the brunt of patient frustration after a DO spends time explaining why they believe a certain medication is the best choice for them, only to have a prior authorization request fail. 

It is this type of real-world feedback DOs share that undergirds POMA’s fight to achieve legislative reform on prior authorization.  The main goal is for physicians to know what is covered by a patient’s insurer from the beginning of the patient visit. POMA is working in a coalition of patients, providers and hospitals supporting reform. Stay tuned for an advocacy alert coming in early March on this issue!