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Lawmakers take on prior authorization reform as health insurance frustrations mount (www.theguardian.com)

submitted 6 days ago by [email protected] to c/[email protected]

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Summary

Lawmakers and physicians are targeting prior authorization reforms as frustrations with health insurance grow.

Prior authorization, initially designed to control costs, now delays even basic, low-cost treatments, with 24% of doctors reporting serious patient harm due to denials, according to the AMA.

Reforms have been introduced at state and federal levels, including rules to streamline processes.

Critics argue the system creates unnecessary administrative burdens, with providers facing confusing, inconsistent requirements.

Physicians claim insurers profit at the expense of patients, as delays persist for essential medications like asthma treatments.

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[–] pelespirit 18 points 6 days ago

It gives the insurance companies all of the power to decide if you get treatment or not. That's the real issue, insurance companies shouldn't have a say. If they don't make any money, then get out of the business.

[–] [email protected] 10 points 6 days ago

I am concerned that this will turn into a post-authorization nightmare, e.g. hospital stay is denied after the fact — or just never approved to begin with, chronologically out of order due to response times — leading hospitals to ask for shit like deposits or credit checks. Capitalism will just shift “the burden” of patient care elsewhere. The next four years sure won’t reform anything either.