Nearly one in five people with health insurance have experienced delays or denials of care due to prior authorization requirements. Prior authorization is a process that requires patients to obtain approval from their insurer before receiving certain services. Insurers argue that this is a cost-saving measure that prevents unnecessary and ineffective care. However, it has been criticized for creating barriers to care for patients and adding paperwork for providers.
To address these concerns, new rules have been implemented regarding how insurers use prior authorization in various healthcare plans. These rules aim to make the process more efficient and transparent for both patients and providers. Meanwhile, lawmakers are considering broader legislation on the topic of prior authorization.
On February 22 at noon ET, a panel of experts will discuss the future of prior authorization requirements in healthcare. The panelists, including Troyen Brennan, MD, Fumiko Chino, MD, Anna Schwamlein Howard, and Kaye Pestaina, will examine the reasons behind using prior authorization, its impact on patients and providers, and how the new regulations may change current practices. Additionally, they will consider potential future regulatory or legislative action to address ongoing concerns.
Larry Levitt, Executive Vice President for Health Policy at KFF, will moderate this event as part of KFF’s virtual Health Wonk Shop series. This series offers in-depth policy discussions with experts beyond the news headlines.