KFF Health News
•“It’s not worth the fight to get my medical treatment,” Missouri man says
81% Informative
The process is called “prior authorization,” or sometimes “pre-certification” A tool insurers say they use to rein in costs and protect patients from unnecessary or ineffective medical treatment.
Last year , lawmakers in 29 states and Washington , D.C. , considered 90 bills to limit prior authorization requirements.
The American Medical Association expects more bills this year .
In Missouri , state and national organizations representing doctors, nurses, social workers, and hospitals back Stinnett ’s bill.
Opposition to the plan comes largely from pharmacy benefit managers and insurance industry.
Manual submissions accounted for 39% of prior authorization requests for prescriptions and 60% of medical services.