prior-authorization

International Pain Foundation works to develop a standardized prior authorization form for prescription drugs, not to exceed two pages in length, and to make the form electronically available and transmissible in every state. The bill would also allow for the electronic notification of the approval or denial of the authorization request.

Currently, there are over 100 million Americans’ who struggle with the challenges of living daily with chronic pain. These patients and their physicians must go through an arduous and cumbersome prior authorization process for many of the prescription drugs our community relies on to live productive lives and to complete daily tasks. Physicians and pharmacist report that roughly 4-20 hours are needed each week just to complete and process prior authorization forms and many times physicians wait several days just to receive the proper authorization forms for medications. This lengthy process leads to major delays in patient care and requires physicians and pharmacists to continually follow-up on authorization requests in order to prescribe or fill a medication.

Health insurers are increasingly interfering in the provider-patient relationship. The PA process is currently highly complex, lacks transparency, and the criteria and processes vary significantly among health plans. Many health plans have differing pre-authorization, appeal, benefit advisory, and admission notification requirements; and these differing requirements create training and logistical complexity for providers, as their staff tries to keep track of the various requirements and the different methods of communicating the information. In recent surveys by the Arizona Medical Association and the Arizona Osteopathic Medical Association it showed at least 98% of MD’s and DO’s agreed that the prior authorization process interrupts patient care and that a more simplified process is needed.

International Pain Foundation, strongly supports legislation which will streamline the prior authorization process, benefiting physicians (and their staff), pharmacists, and, most importantly, patients.

Translate »