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AMA and Several National Organizations Release Statement on Prior Authorization

Posted by AAST Editor on Mar 1, 2018 11:43:11 AM

Last month, the American Medical Association (AMA) released a Consensus Statement on Improving the Prior Authorization Process, with the American Hospital Association, America’s Health Insurance Plans, American Pharmacists Association, the Blue Cross Blue Shield Association, and the Medical Group Management Association.

The consensus statement addresses five key areas for improvement in prior authorization programs:

  • Selective application of prior authorization
  • Prior authorization program review and volume adjustment
  • Transparency and communication regarding prior authorization
  • Continuity of patient care
  • Automation to improve transparency and efficiency

According to the statement, the organizations wrote:

“We have partnered to identify opportunities to improve the prior authorization process, with the goals of promoting safe, timely, and affordable access to evidence-based care for patients; enhancing efficiency; and reducing administrative burdens.”

We suggest that you watch for insurance carrier communications for updates on pre-certification medical policies.