Uniform Prior Authorization
What’s the issue?
In an effort to contain costs, most health insurers require physicians to obtain prior authorization before prescribing certain medications and health services. Most medical practices contract with multiple insurance companies, each with its own approval process. What’s more, each of those companies frequently utilize a different form for each test, procedure, service, or medication requested.
What this means for patients:
Research has shown that the average physician spends 3 weeks a year interacting with health plans. This administrative burden not only distracts from the provision of high quality care, but also increases payer costs significantly. In 2012, prior authorizations cost the health system $728 million. Today, that figure has increased to just fewer than 1 billion dollars annually.
The Florida Society of Rheumatology supports a uniform prior authorization form for all insurers that can be easily accessed by physicians. We strongly suggest that this form be no more than two pages in length and must be made available for both access and submission electronically. Furthermore, we support legislation that deems approval for requests that receive no response within 48 hours of submission. If this can be achieved, a severe economic burden will be lifted from the shoulders of Florida’s patients.