As you may know, health insurance plans, including many Medicare Advantage plans, require physicians and other health care providers to obtain pre-approval for certain medical treatments or tests before they can provide care to their patients. Known as
prior authorization, this process is meant to control costs by reducing medically unnecessary tests and procedures. Physicians, other health care providers, and patients tell us that many health plans are over-using prior authorization and creating needless
treatment delays and denials which may endanger Medicare patients’ health. We also know that this process can be lengthy and require physicians, other health care providers, or their staff to waste two or more days each week negotiating with insurance companies
— time that would better be spent taking care of patients.