1. The American Academy of Ophthalmology commented on CMS’ proposed prior authorization rule and suggested four changes.
2. According to the most recent data from the Kaiser Family Foundation, more than 35 million prior authorization requests were submitted to Medicare Advantage plans in 2021. Of those requests, more than 2 million were fully or partially denied by Medicare Advantage insurers.
3. UnitedHealthcare, an insurer of 45 million patients worldwide, announced changes to its prior authorization requirements for gastroenterology care, set to take effect June 1.
4. Sixty-four percent of physicians say that prior authorization has led to ineffective initial treatments for patients, according to a report from the American Medical Association.
5. Physicians and staff spend an average of two whole workdays per week completing prior authorizations, taking them away from patients and patient care for about 14 hours a week, according to a report from the AMA.
6. For patients whose treatment requires prior authorization, the process delays access to necessary medical care from physicians 94 percent of the time, according to a report from the AMA.
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