POLITICO Q&A: American Medical Association President Jack Resneck

Resneck talks to POLITICO about the group’s challenges — from legal threats to AI — as he prepares to step down.

POLITICO
“CMS estimates that efficiencies introduced through these policies would save physician practices and hospitals over $15 billion over a 10-year period.” #fixpriorauth #medicineforward https://www.healthcarefinancenews.com/news/current-prior-authorization-practices-are-adding-burnout-surgeon-general-says
Current prior authorization practices are adding to burnout, surgeon general says

CMS estimates that efficiencies introduced through the new rule would save practices and hospitals over $15 billion over a 10-year period.

Healthcare Finance News
Have a Prior Auth Problem? Introducing 'Gatekeepers of Care,' Medscape's New Series on Challenges Accessing Cancer Treatment

This new column will explore the ways in which insurance companies may dictate or restrict cancer care. Each month, oncologists and patients will share their experiences. But first, how did we get here?

Medscape
“Mind-Numbing” Mental Health Prior Authorization Process Discussed at Senate Hearing - Senator Roger Marshall

(Washington, D.C., November 30, 2022) – U.S. Senator Roger Marshall, M.D. today at a Senate HELP Subcommittee hearing discussed the mental health crisis currently wreaking havoc across the nation and the issues patients and health care providers face when it comes to seeking care through the outdated prior authorization process. Senator Marshall brought up his legislation, the Improving […]

Senator Roger Marshall
Appears to be strong industry support for @[email protected] electronic prior auth push. I'm glad to have more people backing it ...AND let's make sure real people are the primary beneficiaries of an improved system (not big business). #FixPriorAuth
https://www.beckerspayer.com/payer/4-reactions-to-cms-prior-authorization-improvement-proposal.html
4 reactions to CMS' prior authorization improvement proposal

CMS' Dec. 6 proposal to improve the prior authorization process was met positively from groups ranging from America's Health Insurance Plans to the Medical Grou

MRI ordered for pt with lumbar DDD & severe sciatica with paresthesia for months. Can't stand to do work. No improvement with conservative treatment. Prior auth peer denied b/c "doesn't meet medical necessity". Wrote appeal w/ exactly same info and it was approved. #FixPriorAuth
Very glad to see @[email protected] put the pressure on prior auth. And, I like that 2026 deadline. Not far from @[email protected]'s goal of advocating for zero friction by 2025. #FixPriorAuth
https://www.fiercehealthcare.com/payers/cms-proposes-certain-payers-implement-electronic-prior-authorization-systems-2026
CMS proposes certain payers implement electronic prior authorization systems by 2026

The Biden administration released a proposal which, if finalized, would mandate Medicare Advantage (MA), Medicaid managed care, Affordable Care Act (ACA) plans and state Medicaid agencies implement | CMS issued a proposal rule to implement electronic prior authorization by 2026 for Medicare Advantage, ACA and Medicaid managed care plans, replacing a 2020 rule that was withdrawn.

Fierce Healthcare
Today's prior auth: Followup lung CT recommended by radiology because of concerning masslike opacity in 90-pack-year smoker. All info clearly in patient's chart. Why did I need to do a peer-to-peer again? @[email protected] @[email protected] #FixPriorAuth
Hey Texas docs, does anyone actually have a prior auth "gold card" yet? If so, what do you think of it? #FixPriorAuth @[email protected] @[email protected]

I'm in the process of cutting down my health policy book from 153,000 words to ~100,000 words, and this is my first read-through of the manuscript in a couple of months.

Almost forgot how depressing and infuriating it is. Almost.

But it is a real gift to be able to share these stories of the trials of navigating health insurance barriers to coverage. Feeling honored, and hoping to do justice to these patient and physician experiences. #healthpolicy #FixPriorAuth