Timely Care Over Bureaucracy: A Call for Prior Authorization Reform
Imagine being in excruciating pain, knowing relief is within reach—only to be stalled by a broken system. A few months ago, a patient needed an MRI to diagnose a severe condition. Instead of timely care, she faced a prior auth roadblock: the MRI request was denied, pending more information. While waiting for another physician to resubmit the request and secure approval, she endured over a month of debilitating pain.
When her condition was finally confirmed, she required epidural injections. Once again, prior authorization delays forced her to repeatedly reschedule treatment. Every rescheduled appointment and every extra day in pain was not just frustrating—it was costly. The delayed care compounded her suffering, likely worsening her condition, and potentially increasing future medical expenses.
This experience highlights why the Medical Association and the 30-plus member coalition for prior authorization reform are strongly advocating for specific changes, including a 24-hour response time for urgent requests and a 48-hour response time for non-urgent ones. Delayed care causes unnecessary suffering for patients and often results in the need for more costly interventions later, exacerbating the strain on an already overburdened healthcare system.
Prior authorizations are meant to ensure appropriate care, but when they create barriers to timely treatment, they fail patients and escalate costs. It’s time to prioritize efficient care over bureaucratic delays—because every day of waiting matters.