Prior authorization continues to delay patient care and treatment, impact outcomes, and drive up health care costs for all Hoosiers. Physician offices advocate for their patients but are forced to waste valuable time and resources on these burdens.
  
Your stories about how prior authorization impacts patients are a powerful way to help ISMA put Patients Over Prior Auth.
  
Please participate in ISMA’s newest advocacy initiative by sending us the latest example(s) of payors inappropriately putting prior auth over patients. Almost 90 stories have already been submitted to ISMA since the short intake form went live.

There is no limit on the number of submissions you can make. In fact, the more examples we have, the more impactful it will be -- even if they are repetitive. 

Douglas Neeld, MD, submitted, “I was attempting to get one of my asthmatic patients a combination inhaler (i.e. Advair). It was denied and came with a letter stating the other three options in the drug class that were covered (Symbicort, Dulera and Breo). Every time I sent another inhaler in, I received a refusal saying the OTHER three inhalers were covered. I did this until I exhausted all four inhalers in the class, leaving me with no option for my patient. This has happened more than once. It was Indiana Medicaid. The denials came with no contact information. I was forced to give my patient systemic steroids (more potential side effects) and inhalers that were not in keeping with current therapeutic guidelines. If I can prevent an ER visit with the proper medications, everyone wins.”

Visit www.ismanet.org/PatientsOverPriorAuth to share your story and read several others. 

Please consider sharing this article with your colleagues, even if they’re not ISMA members. We want to hear from as many Hoosier physicians as possible. 

Thank you for continuing to advocate for the well-being of all Hoosiers. Your participation in this Patients Over Prior Auth initiative will help bring about vital change.

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