By Soumi Saha, Senior Vice President, Government Affairs, Premier Inc.
Modernizing prior authorization for Medicare Advantage patients is vital to reducing the delayed care, harm and costs, which are the legacy of an antiquated process requiring faxes and phone calls in time-sensitive clinical situations. Premier applauds Sens. Roger Marshall (R-KS), Sherrod Brown (D-OH), John Thune (R-SD) and Krysten Sinema (I-AZ) and Reps. Suzan DelBene (D-WA), Mike Kelly (R-PA), Larry Bucshon (R-IN) and Ami Bera (D-CA) for their efforts to make electronic prior authorization a long-overdue reality. This legislation would benefit millions of America’s seniors, reduce clinician burden, improve evidence-based healthcare and reduce costs.
The results of a recent Premier survey of hospitals revealed the alarming scope of delays and denials of medical claims by Medicare Advantage plans, which threatens patient access to care when they need it and costs healthcare providers $19.7 billion a year to process claims. Bringing prior authorization processes into the 21st century and injecting greater transparency in the process will help remove these barriers to timely, high-quality equitable care.
Premier urges Congress to bring common sense reform and transparency to prior authorization by passing the bipartisan, bicameral Improving Seniors Timely Access to Care Act. In addition, Congress and the Administration should go a step further and establish incentives for healthcare providers to continue the movement to electronic, real-time prior authorization.
