Prior authorization is 'No. 1 physician and administrative concern in America,' senator says

The sponsor of the Senate's version of a bill to reform the Medicare Advantage prior authorization process called prior authorization the "No. 1 physician and administrative concern in America."

Kansas Sen. Roger Marshall, MD, said that as an OB-GYN, he saw the issue delay care for infertility patients and high-risk patients, according to a Nov. 30 news release from his office. 

Dr. Marshall was speaking during a subcommittee hearing on mental health. Other speakers at the hearing concurred with Dr. Marshall, according to the release. Among them was Ashley Weiss, DO, director of medical student education in psychiatry at the Tulane University School of Medicine in New Orleans. She called the prior authorization process "mind-numbing" and said it can sometimes take weeks to get prior authorization for community-based mental health services." 

Dr. Marshall's version of the Improving Seniors' Timely Access to Care Act is currently under consideration in the Senate. The House unanimously passed its version of the bill in September. Among other things, the bill would establish an electronic prior authorization process and require Medicare Advantage plans to report to CMS the extent of their use of prior authorization and the rate of approvals or denials.

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