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 advocacy initiative by sending us the latest example(s) of payors inappropriately putting prior auth over patients. More than 110 stories have already been submitted to ISMA since the short intake form went live earlier this year.
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.
Lois K. Lambrecht, MD, shared, “OptumRx prescription for Percocet. (My patient) has been on it for the past 15 years: same diagnoses, same insurance. I don't have electronic medical records and can't upload documentation, thus it was being denied. I asked for an expedited case, but it was denied as I didn't have the required documentation, such as a signed agreement, etc. However, no documentation specifics were included in the PA. I called and spent 15 minutes on the phone. Then, a pharmacist who left no name or return phone number requested the documentation I needed to provide, but there was no way to get it to them. Twenty additional minutes were spent waiting to speak with a "peer" who asked if I would attest to the documents needed. They then told us they would let us know if it was approved. My patient was without their medication for five days. Two years ago, I spent 85 minutes on this patient's PA. PAs adversely affect everyone.”
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.
Patients Over Prior Auth - FAQs >>