October 2022

• MedPage Today. The Medicare Advantage Trade-Off: Saving Money, Losing Access. October 14, 2022. Cheryl Clark. https://www.medpagetoday.com/special-reports/exclusives/101213?xid=nl_mpt_morningbreak2022-10-14&eun=g744827d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=MorningBreak_101422&utm_term=NL_Gen_Int_Daily_News_Update_active.
• Healthcare Finance. Regulatory challenges increasing among medical practices. October 14, 2022. Jeff Lagasse. https://www.healthcarefinancenews.com/news/regulatory-challenges-increasing-among-medical-practices.
• Chief Healthcare Executive. ‘Unsustainable’: Medical groups say regulatory burdens are rising, and hurting patients. October 13, 2022. Ron Southwick. https://www.chiefhealthcareexecutive.com/view/-unsustainable-medical-groups-say-regulatory-burdens-are-rising-and-hurting-patients.
• Health Leaders. A recent survey says prior authorization requirements and other regulatory burdens are weighing heavy on providers. October 13, 2022. Amanda Norris. https://www.healthleadersmedia.com/revenue-cycle/prior-authorization-requirements-ranked-top-burden-revenue-cycle.
• MedCity News. Bill mandating electronic prior authorizations may not improve care quality. October 13, 2022. Amanda James. https://medcitynews.com/2022/10/bill-mandating-electronic-prior-authorizations-may-not-improve-care-quality/.
• PR Newswire. MGMA Report Reveals Significant Increase in Regulatory Burden on Medical Practices. October 12, 2022. https://www.prnewswire.com/news-releases/mgma-report-reveals-significant-increase-in-regulatory-burden-on-medical-practices-301647720.html.
• Medical Economics. MGMA 2022: As COVID-19 goes away, regulatory burdens spring up to occupy physicians. October 11, 2022. Richard Payerchin. https://www.medicaleconomics.com/view/as-covid-19-goes-away-regulatory-burdens-spring-up-to-occupy-physicians.
• Home Health Care News. ‘Care Delayed Is Care Denied’: What Prior Authorization Changes Mean For Home Health Providers. October 10, 2022. Patrick Filbin. https://homehealthcarenews.com/2022/10/care-delayed-is-care-denied-what-prior-authorization-changes-mean-for-home-health-providers/.
• Medical Economics. How to improve the prior authorization process for Medicare Advantage. October 6, 2022. Todd Shryock. https://www.medicaleconomics.com/view/how-to-improve-the-prior-authorization-process-for-medicare-advantage.
• News Medical. Study analyzes the benefits and harms of prior authorization policies for Medicare. October 3, 2022. Emily Henderson, B.Sc. https://www.news-medical.net/news/20221003/Study-analyzes-the-benefits-and-harms-of-prior-authorization-policies-for-Medicare.aspx.

September 2022

• Chief Healthcare Executive. Reform to prior authorization could be coming. September 26, 2022. Ron Southwick. https://www.chiefhealthcareexecutive.com/view/reform-to-prior-authorization-could-be-coming.
• American Hospital Association. AHA special edition podcast on prior authorization and health care costs. September 23, 2022. https://www.aha.org/news/headline/2022-09-23-aha-special-edition-podcast-prior-authorization-and-health-care-costs.
• MedCityNews. AHA: Legislative action needed to prevent MA plans from harming Medicare beneficiaries. September 21, 2022. Marissa Plescia. https://medcitynews.com/2022/09/aha-legislative-action-needed-to-prevent-ma-plans-from-harming-medicare-beneficiaries/.
• McKnights. Medicare Advantage enrollees get less post-acute care than traditional beneficiaries: analysis. September 19, 2022. Joe Bush. https://www.mcknights.com/news/medicare-advantage-enrollees-get-less-post-acute-care-than-traditional-beneficiaries-analysis/.
• Medscape. House Passes Prior Authorization Bill, Senate Path Unclear. September 19, 2022. Kerry Dooley Young. https://www.medscape.com/viewarticle/981011.
• Healthcare Innovation. House Passes Medicare Advantage Prior Authorization Bill. September 16, 2022. David Raths. https://www.hcinnovationgroup.com/policy-value-based-care/medicare-medicaid/news/21281002/house-passes-medicare-advantage-prior-authorization-bill.
• American Hospital Association. We Must Keep Our Hospitals Strong as Severe Financial Challenges Threaten Access to Care. September 16, 2022. Rick Pollack. https://www.aha.org/news/perspective/2022-09-16-we-must-keep-our-hospitals-strong-severe-financial-challenges-threaten.
• AMA. House voice vote sets U.S. on path to fix prior authorization. September 16, 2022. Andis Robeznieks. https://www.ama-assn.org/practice-management/prior-authorization/house-voice-vote-sets-us-path-fix-prior-authorization.
• Pharmacy Times. The Impact of Prior Authorization on Patients With Cancer. September 15, 2022. Josh Marsh. https://www.pharmacytimes.com/view/the-impact-of-prior-authorization-on-patients-with-cancer.
• Becker’s Payer Issues. House passes prior authorization reform bill: 4 things to know. September 15, 2022. Andrew Cass. https://www.beckerspayer.com/payer/house-passes-prior-authorization-reform-bill-4-things-to-know.html.
• Modern Healthcare. House passes Medicare Advantage prior authorization oversight bill. September 14, 2022. Maya Goldman. https://www.modernhealthcare.com/politics-policy/medicare-advantage-prior-authorization-bill-passes-house.
• Powers. U.S. House of Representatives Passes Legislation to Streamline Prior Authorization in the Medicare Advantage Program. September 14, 2022. https://www.powerslaw.com/u-s-house-of-representatives-passes-legislation-to-streamline-prior-authorization-in-the-medicare-advantage-program/
• Becker’s Healthcare. Physicians urge CMS to ease medical practice burdens. September 13, 2022. Alan Condon. https://www.beckersasc.com/asc-news/physicians-urge-cms-to-ease-medical-practice-burdens.html.
• Cision PR Newswire. Surgical Care Coalition Statement on Supporting Medicare Providers Act of 2022. Septe,ner 13, 2022. https://www.prnewswire.com/news-releases/surgical-care-coalition-statement-on-supporting-medicare-providers-act-of-2022-301623712.html.
• Becker’s Healthcare. American Academy of Ophthalmology calls on CMS to address Medicare Advantage. September 8, 2022. Claire Wallace. September 8, 2022. https://www.beckersasc.com/ophthalmology/american-academy-of-ophthalmology-calls-on-cms-to-address-medicare-advantage.html.
• Revcycle Intelligence. MGMA Calls for Prior Authorization Reform in Medicare Advantage. September 7, 2022. Victoria Bailey. https://revcycleintelligence.com/news/mgma-calls-for-prior-authorization-reform-in-medicare-advantage.
• Bloomberg Law. Limits on Prior Authorization Urged for Private Medicare Plans. September 1, 2022. Tony Pugh. https://news.bloomberglaw.com/health-law-and-business/limits-on-prior-authorization-urged-for-private-medicare-plans

August 2022

• Medical Economics. Prior authorizations and Medicare reimbursement: what you need to know. August 31, 2022. Keith A. Reynolds. https://www.medicaleconomics.com/view/prior-authorizations-and-medicare-reimbursement-what-you-need-to-know.
• The Role Of Technology In Improving The Prior Authorization Consumer Experience. August 17, 2022. Tammy Hawes. https://www.forbes.com/sites/forbestechcouncil/2022/08/17/the-role-of-technology-in-improving-the-prior-authorization-consumer-experience/?sh=5dca71ab64e3.
• Yahoo! Finance. Kidney Patients Cite Insurance and Payment Issues as Critical Barriers to FDA Approved Care Innovations. August 15, 2022. https://finance.yahoo.com/news/kidney-patients-cite-insurance-payment-232900709.html.
• MedCity News. American Hospital Association turns up the heat on commercial insurers in scathing report. August 9, 2022. Marissa Plescia. https://medcitynews.com/2022/08/american-hospital-association-turns-up-the-heat-on-commercial-insurers-in-scathing-report/.
• California Medical Association. House committee advances bill that will reform Medicare Advantage prior auth. August 9, 2022. https://www.cmadocs.org/newsroom/news/view/ArticleId/49847/House-committee-advances-bill-that-will-reform-Medicare-Advantage-prior-auth.
• Modern Healthcare. CMS removes prior authorization for select orthopedic devices. August 9, 2022. Alex Kacik. https://www.modernhealthcare.com/payment/cms-removes-prior-authorization-select-orthopedic-devices.
• Policy & Medicine. HHS OIG Reviews Prior Authorization Denials. August 6, 2022. Thomas Sullivan. https://www.policymed.com/2022/08/hhs-oig-reviews-prior-authorization-denials.html.
• Policy & Medicine. Improving Seniors’ Timely Access to Care Act of 2022 Entering Markup Phase. August 6, 2022. Thomas Sullivan. https://www.policymed.com/2022/08/improving-seniors-timely-access-to-care-act-of-2022-entering-markup-phase.html.
• Modern Healthcare. Congress eyes faster Medicare Advantage prior authorizations. August 4, 2022. Maya Goldman. https://www.modernhealthcare.com/politics-policy/medicare-advantage-prior-authorization-bill-nearing-passage.
• Michigan State Medical Society. TAKE ACTION: Tell Congress to Get Our Health Care System Back on Track. August 3, 2022. https://www.msms.org/About-MSMS/News-Media/take-action-tell-congress-to-get-our-health-care-system-back-on-track.
• Community Oncology Alliance Strongly Supports the Improving Seniors’ Timely Access to Care Act of 2022. August 3, 2022. https://www.einnews.com/pr_news/584302073/community-oncology-alliance-strongly-supports-the-improving-seniors-timely-access-to-care-act-of-2022.
• Greater New York Hospital Association. House Committee Advances Medicare Advantage Prior Authorization Bill. August 1, 2022. https://www.gnyha.org/news/house-committee-advances-medicare-advantage-prior-authorization-bill/.

July 2022

• AMA. What doctors wish patients knew about prior authorization. July 29, 2022. Sara Berg. https://www.ama-assn.org/practice-management/prior-authorization/what-doctors-wish-patients-knew-about-prior-authorization.
• McKnights Long-Term Care News. House committee approves bill that would reform prior authorization under Medicare Advantage program. July 29, 2022. Danielle Brown.  https://www.mcknights.com/news/house-panel-oks-bill-that-would-reform-prior-authorization-under-medicare-advantage-program/.
• HealthLeaders. Several groups have backed the Seniors’ Timely Access to Care Act, which will now head to the House floor. July 29, 2022. Jay Asser. https://www.healthleadersmedia.com/revenue-cycle/widely-supported-medicare-advantage-prior-authorization-bill-advances-house.
• AMA. Big step for bill to streamline prior auth in Medicare Advantage. July 29, 2022. Kevin B. O’Reilly. https://www.ama-assn.org/practice-management/prior-authorization/big-step-bill-streamline-prior-auth-medicare-advantage.
• American Hospital Association. Protecting Access to Care by Confronting Commercial Insurers’ Harmful Policies. July 29, 2022. Rick Pollack. https://www.aha.org/news/perspective/2022-07-29-protecting-access-care-confronting-commercial-insurers-harmful-policies.
• Becker’s Spine Review. Neurosurgeons urge Congress to pass bill addressing prior authorization by year’s end. July 29, 2022. Alan Condon. https://www.beckersspine.com/spine/item/54849-neurosurgeons-urge-congress-to-pass-bill-addressing-prior-authorization-by-year-s-end.html.
• American Hospital Association. AHA Voices Support for the Improving Seniors’ Timely Access to Care Act of 2022 (H.R. 8487). July 27, 2022. https://www.aha.org/lettercomment/2022-07-27-aha-voices-support-improving-seniors-timely-access-care-act-2022-hr-8487
• American Academy of Ophthalmology. House Panel Advances Prior Authorization Relief Bill. July 27, 2022. https://www.newswise.com/politics/house-panel-advances-prior-authorization-relief-bill/?article_id=775417.
• Committee on Ways And Means. Buchanan: “Seniors’ Access to Timely Care Act” Brings Prior Authorization into the 21st Century. July 27, 2022. https://gop-waysandmeans.house.gov/buchanan-seniors-access-to-timely-care-act-brings-prior-authorization-into-the-21st-century/.
• American Hospital Association. AHA-supported bill to streamline MA prior authorization advances in House. July 27, 2022. https://www.aha.org/news/headline/2022-07-27-aha-supported-bill-streamline-ma-prior-authorization-advances-house.
• MedPage Today. House Committee Advances Bill to Streamline Prior Authorization. July 27, 2022. Joyce Frieden. https://www.medpagetoday.com/practicemanagement/reimbursement/99935.
• AMA. “Gold card” approach to prior authorization introduced in Congress. July 26, 2022. Kevin B. O’Reilly. https://www.ama-assn.org/practice-management/prior-authorization/gold-card-approach-prior-authorization-introduced-congress.
• 13WIBW. 500+ advocacy groups endorse legislation to improve health care access. July 19, 2022. Sarah Motter. https://www.wibw.com/2022/07/19/500-advocacy-groups-endorse-legislation-improve-health-care-access/.
• Fox News. Insurance delays hurt patients and doctors, but Congress can fix it. July 18, 2022. Jonathan Crowe. https://www.foxnews.com/opinion/insurance-delays-hurt-patients-doctors-congress-can-fix-it.
• HealthLeaders. CMS May be Adding to Prior Authorization Problem. July 18, 2022. Amanda Norris. https://www.healthleadersmedia.com/revenue-cycle/cms-may-be-adding-prior-authorization-problem.
• HealthLeaders. The American Hospital Association (AHA) urged Congress to streamline Medicare Advantage plans’ prior authorization requirements in lengthy letter. July 13, 2022. Amanda Norris. https://www.healthleadersmedia.com/revenue-cycle/medicare-advantage-plans-need-be-held-accountable-aha-says
• Better Medicare Alliance. Better Medicare Alliance Endorses Bipartisan Senate Bill to Simplify Prior Authorization for Seniors. July 12, 2022. https://bettermedicarealliance.org/news/better-medicare-alliance-endorses-bipartisan-senate-bill-to-simplify-prior-authorization-for-seniors/.
• Health Affairs. Reframe The Role Of Prior Authorization To Reduce Low-Value Care. July 11, 2022. A Mark Fendrick. https://www.healthaffairs.org/do/10.1377/forefront.20220708.54139.
• American Medical Association. Prior authorization delays even reach congresswoman’s family. July 7, 2022. Jennifer Lubell. https://www.ama-assn.org/practice-management/prior-authorization/prior-authorization-delays-even-reach-congresswoman-s.
• InsideBIGDATA. Reforming Prior Authorization with AI and Machine Learning. July 7, 2022. https://insidebigdata.com/2022/07/07/reforming-prior-authorization-with-ai-and-machine-learning/.
• Becker’s Spine Review. Orthopedic patient’s death highlights potential dangers of prior authorization. July 5, 2022. Alan Condon. https://www.beckersspine.com/orthopedic/item/54635-orthopedic-patient-s-death-highlights-potential-dangers-of-prior-authorization.html.
• ModernHealthcare. Dueling Opinions: Priorities related to prior authorization. July 5, 2022. Kate Berry and Dr. Jack Resneck Jr. https://www.modernhealthcare.com/opinion/dueling-opinions-priorities-related-prior-authorization?adobe_mc=MCMID%3D13521559178440516762033965770842225564%7CMCORGID%3D138FFF2554E6E7220A4C98C6%2540AdobeOrg%7CTS%3D1657550793&CSAuthResp=1%3A%3A81752%3A7533%3A24%3Asuccess%3AB3D06D7C3569BE1F4EEC00BA10B3B03A.
• Eyewire News. Aetna Drops Prior Authorization for Most Cataract Surgeries. July 5, 2022. https://eyewire.news/news/aetna-drops-prior-authorization-requirement-for-cataract-surgery?c4src=article:infinite-scroll
• AJMC. Aetna to Halt Prior Authorization Requirement for Cataract Surgeries July 1, 2022. Julia Bonavitacola. https://www.ajmc.com/view/aetna-to-halt-prior-authorization-requirement-for-cataract-surgeries.
• Medscape. Insurer Delays Prior Authorization, Patient Loses Leg and Pelvis, Then Dies. July 1, 2022. Alicia Gallegos. https://www.medscape.com/viewarticle/976486.
• Healthcare Finance News. Aetna rolls back policy requiring pre-approval for cataract surgery. July 1, 2022. Susan Morse. https://www.healthcarefinancenews.com/news/aetna-rolls-back-policy-requiring-pre-approval-cataract-surgery.
• Business Insurance. In reversal, Aetna drops pre-authorization requirement for cataract surgery. July 1, 2022. https://www.businessinsurance.com/article/20220701/STORY/912350892/In-reversal,-Aetna-drops-pre-authorization-requirement-for-cataract-surgery.

June 2022

• Healthcare Dive. Aetna rolls back prior authorization requirement for cataract surgery. June 30, 2022. Shannon Munchmore. https://www.healthcaredive.com/news/aetna-prior-authorization-requirement-cataract-surgery/626430/.
• Fierce Healthcare. Aetna to roll back controversial prior authorization policy for cataract surgery. June 30, 2022. Paige Minemyer. https://www.fiercehealthcare.com/payers/aetna-roll-back-controversial-prior-authorization-policy-cataract-surgery.
• Healio. Aetna reverses policy requiring pre-approval for cataract surgery. June 30, 2022. https://www.healio.com/news/ophthalmology/20220630/aetna-reverses-policy-requiring-preapproval-for-cataract-surgery.
• Ophthalmology Times. Aetna drops policy requiring prior authorization for cataract surgery in 48 states. June 30, 2022. David Hutton. https://www.ophthalmologytimes.com/view/aetna-drops-policy-requiring-prior-authorization-for-cataract-surgery-in-48-states.
• American Medical Association. Cancer killed Kathleen Valentini, but prior auth shares the blame. June 16, 2022. Tanya Albert Henry. https://www.ama-assn.org/practice-management/prior-authorization/cancer-killed-kathleen-valentini-prior-auth-shares-blame.
• Bloomberg Law. Backlash Over Coverage Denials Stings Private Medicare Plans. June 15, 2022. Tony Pugh. https://news.bloomberglaw.com/health-law-and-business/backlash-over-coverage-denials-stings-private-medicare-plans.
• American Medical Association. In 2018, payers agreed to rein in prior auth. The clock is ticking. June 10, 2022. Andis Robeznieks. https://www.ama-assn.org/practice-management/prior-authorization/2018-payers-agreed-rein-prior-auth-clock-ticking.
• MedPage Today. Prior Authorization Back in the Spotlight on Capitol Hill. June 6, 2022. Joyce Frieden. https://www.medpagetoday.com/practicemanagement/reimbursement/99094.
• Forbes. Do You Know If Your Medicare Advantage Plan Requires Prior Authorization? June 1, 2022. Diane Omdahl. https://www.forbes.com/sites/dianeomdahl/2022/06/01/do-you-know-if-your-medicare-advantage-plan-requires-prior-authorization/?sh=665ab59841ac.

May 2022

• The National Law Review. HHS OIG Report On Prior Authorizations Under Medicare Advantage. May 31, 2022. Christine M. Clements. https://www.natlawreview.com/article/hhs-oig-report-prior-authorizations-under-medicare-advantage.
• Insurance Newsnet. Senate Budget Committee Issues Testimony From National Nurses United. May 31, 2022. https://insurancenewsnet.com/oarticle/senate-budget-committee-issues-testimony-from-national-nurses-united.
• Kaiser Family Foundation. Examining Prior Authorization in Health Insurance. May 30, 2022. Kaye Pestaina and Karen Pollitz. https://www.kff.org/policy-watch/examining-prior-authorization-in-health-insurance/.
• Salon. Frustrated with delays, doctors take aim at prior authorization. May 30, 2022. Lola Butcher. https://www.salon.com/2022/05/30/frustrated-with-delays-doctors-take-aim-at-prior-authorization_partner/.
• Physicians Weekly. AMA Survey Shows Lack of Progress on Prior Authorization Reforms. May 29, 2022. https://www.physiciansweekly.com/ama-survey-shows-lack-of-progress-on-prior-authorization-reforms/.
• Mother Jones. Insurers’ Efforts to Curb Wasteful Spending Are Driving Doctors Nuts. May 28, 2022. Lola Butcher. https://www.motherjones.com/politics/2022/05/medical-spending-prior-authorization-doctors-insurance-paperwork/.
• HealthLeaders Media. Medicare Advantage Advocate Endorses Prior Authorization Bill. May 27, 2022. Jay Asser.  https://www.healthleadersmedia.com/revenue-cycle/medicare-advantage-advocate-endorses-prior-authorization-bill.
• POLITICO Pulse. Four states bolster postpartum care amid mortality crisis. May 26, 2022. Sarah Owermohle and Krista Mahr. https://www.politico.com/newsletters/politico-pulse/2022/05/26/four-states-bolster-postpartum-care-amid-mortality-crisis-00035281.
• Advisory Board. Health care worker burnout at ‘crisis levels,’ warns Surgeon General. May 25, 2022. https://www.advisory.com/daily-briefing/2022/05/25/healthcare-burnout.
• Medical Economics. AMA says health insurance industry failing on prior auth reform. May 25, 2022. Todd Shryock. https://www.medicaleconomics.com/view/ama-says-health-insurance-industry-failing-on-prior-auth-reform.\
• Revcycle Intelligence. Lack of Prior Authorization Reform Escalating Physician Burden. May 25, 2022. Victoria Bailey. https://revcycleintelligence.com/news/lack-of-prior-authorization-reform-escalating-physician-burden.
• MDLinx. Prior Authorization Reform Act: How it could help physicians and patients. May 24, 2022. Samar Mahmoud. https://www.mdlinx.com/article/prior-authorization-reform-act-how-it-could-help-physicians-and-patients/2D3OAH5eOWwaflMTEZdf2V.
• Modern Healthcare. AMA: Insurers not sticking to prior authorizations deal from 2018. May 24, 2022. Maya Goldman. https://www.modernhealthcare.com/insurance/ama-insurers-not-sticking-prior-authorizations-deal-2018.
• South Florida Hospital News. Health Insurance Industry Continues to Falter on Prior Authorization Reform. May 24, 2022. https://southfloridahospitalnews.com/health-insurance-industry-continues-to-falter-on-prior-authorization-reform/.
• Fierce Healthcare. AHA presses for False Claims Act probes to target payers over Medicare Advantage denials. May 23, 2022. Robert King. https://www.fiercehealthcare.com/payers/aha-presses-false-claims-act-probes-target-payers-over-medicare-advantage-denials.
• Becker’s Hospital Review. Breakthroughs in Prior Authorization Automation: An Expert Offers Insights. May 20, 2022. https://www.beckershospitalreview.com/hospital-management-administration/breakthroughs-in-prior-authorization-automation-an-expert-offers-insights.html.
• Kaiser Health News. Why So Slow? Legislators Take on Insurers’ Delays in Approving Prescribed Treatments. May 17, 2022. Michelle Andrews. https://khn.org/news/article/prior-authorization-treatment-insurers-doctors-faster/.
• Imaging Technology News. Increased Access to Care and Reduced Treatment Delays Lead Priorities as Radiation Oncologists Meet with Members of Congress. May 17, 2022. https://www.itnonline.com/content/increased-access-care-and-reduced-treatment-delays-lead-priorities-radiation-oncologists.
• Benefits Pro. State Legislators working to speed up prior authorization process. May 17, 2022. Michelle Andrews. https://www.benefitspro.com/2022/05/17/state-legislators-working-to-speed-up-prior-authorization-process/?slreturn=20220431111614.
• MedPage Today. Faulty Prior Authorization Denials; Smoking & Cancer; Effective Anti-Vaping Messages. May 13, 2022. Charles Bankhead. https://www.medpagetoday.com/hematologyoncology/othercancers/98694.
• American Hospital Association. AHA podcast: New trends in Medicare Advantage plans raise concerns about access to care. May 13, 2022. https://www.aha.org/news/headline/2022-05-13-aha-podcast-new-trends-medicare-advantage-plans-raise-concerns-about.
• Modern Retina. AAO applauds Congress for passage of key milestone for Improving Seniors’ Timely Access to Care Act of 2021. May 12, 2022. David Hutton. https://www.modernretina.com/view/aao-applauds-congress-for-passage-of-key-milestone-for-prior-authorization-reform-bill.
• POLITICO Pulse. Why federal abortion laws won’t pass. May 12, 2022. Sarah Owermohle and Krista Mahr. https://www.politico.com/newsletters/politico-pulse/2022/05/12/why-federal-abortion-laws-wont-pass-00031971.
• American Medical Association. How Medicare Advantage plans wrongly deny prior auth requests. May 11, 2022. Kevin B. O’Reilly. https://www.ama-assn.org/practice-management/sustainability/how-medicare-advantage-plans-wrongly-deny-prior-auth-requests.
• Medscape. Prior Authorizations Delay TNF Inhibitors for Children with JIA. May 11, 2022. Tara Haelle. https://www.medscape.com/viewarticle/973816.
• MedCity News. Overhauling prior authorization: How to achieve better outcomes at a lower cost. May 8, 2022. Brian Covino and Matt Murphy. https://medcitynews.com/2022/05/overhauling-prior-authorization-how-to-achieve-better-outcomes-at-a-lower-cost/.
• Fierce Healthcare. OIG report reignites lawmakers’ push for action on Medicare Advantage prior authorization. May 3, 2022. Robert King. https://www.fiercehealthcare.com/payers/oig-report-prompts-lawmakers-clamor-swift-action-medicare-advantage-prior-authorization.
• American Academy of Orthopaedic Surgeons. AAOS’ Advocacy Efforts Focus on Access to Quality Care. May 2, 2022. Douglas W. Lundy, MD, MBA, FAAOS. https://www.aaos.org/aaosnow/2022/may/advocacy/advocacy01/.

April 2022

• HealthExec. Prior authorization under fire in Inspector General investigation. April 29, 2022. Amy Baxter. https://healthexec.com/topics/healthcare-management/healthcare-policy/prior-authorization-under-fire-oig-investigation.
• U.S. Department of Health and Human Services. Medicare Advantage Denials of Care. April 28, 2022. https://www.youtube.com/watch?v=AisF2d60NlU.
• AMA. Why D.C. Council should act now to fix prior authorization. April 21, 2022. Kevin B. O’Reilly. https://www.ama-assn.org/practice-management/sustainability/why-dc-council-should-act-now-fix-prior-authorization.
• American Gastroenterological Association. Regulatory relief: Prior authorization burdens. April 21, 2022. https://gastro.org/advocacy-and-policy/policies-affecting-gi/regulatory-relief-prior-authorization-burdens/?hilite=prior+authorization.
• McKinsey. AI ushers in next-gen prior authorization in healthcare. April 19, 2022. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/ai-ushers-in-next-gen-prior-authorization-in-healthcare.
• Radiology Business. American Society of Nuclear Cardiology urges Congress to speed prior authorizations, repeal AUC mandate. April 18, 2022. Dave Fornell. https://www.radiologybusiness.com/topics/healthcare-management/healthcare-policy/american-society-nuclear-cardiology-urges-congress.
• MedCity News. Opinion: Insurance company abuses are putting more patients’ care out of reach. April 11, 2022. Terry Wilcox. https://medcitynews.com/2022/04/insurance-company-abuses-are-putting-more-patients-care-out-of-reach/.
• Oncology Nursing News. ASCO Calls for Necessary Improvements to Electronic Prior Authorization. April 7, 2022. https://www.oncnursingnews.com/view/asco-calls-for-necessary-improvements-to-electronic-prior-authorization.
• U.S. Congresswoman Suzan DelBene. Press Release: Mental Health Groups Endorse Bipartisan Prior Authorization Legislation. April 5, 2022. https://delbene.house.gov/news/documentsingle.aspx?DocumentID=3109.
• POLITICO Pulse. Senate $10B deal on Covid aid comes at too high a price, critics say. April 5, 2022. https://www.politico.com/newsletters/politico-pulse/2022/04/05/senate-10b-deal-on-covid-aid-comes-at-too-high-a-price-critics-say-00022929.
• Healio. Cataract surgery prior authorization an unnecessary burden for practices. April 01, 2022. https://www.healio.com/news/ophthalmology/20220330/cataract-surgery-prior-authorization-an-unnecessary-burden-for-practices.

March 2022

• Medpage Today. PBM Called for a Prior Authorization? That’s News to Me! March 28, 2022. Fred N. Pelzman. https://www.medpagetoday.com/opinion/patientcenteredmedicalhome/97910.
• Managed Healthcare Executive. Fixing Prior Authorization: How to Improve Outcomes Using Episodic Care Paths. March 24, 2022. Matt Murphy. https://www.managedhealthcareexecutive.com/view/fixing-prior-authorization-how-to-improve-outcomes-using-episodic-care-paths.
• Revcycle Intelligence. AHA: Electronic Prior Authorization Implementation Requires Testing. March 22, 2022. Victoria Bailey. https://revcycleintelligence.com/news/aha-electronic-prior-authorization-implementation-requires-testing.
• AHMC. Prior Authorization Woes Could Lead to Lawsuit, Former AMA President Says at COA. March 18, 2022. Mary Caffrey. https://www.ajmc.com/view/prior-authorization-woes-could-lead-to-lawsuit-former-ama-president-says-at-coa.
• American Hospital Association. AHA Comments on Potential Rulemaking to Improve Electronic Prior Authorization Processes. March 18, 2022. https://www.aha.org/lettercomment/2022-03-18-aha-comments-potential-rulemaking-improve-electronic-prior-authorization.
• HealthLeaders. 3 Facts and 3 Predictions for Prior Authorization. March 10, 2022. Laura Beerman. https://medcitynews.com/2022/04/insurance-company-abuses-are-putting-more-patients-care-out-of-reach/.
• AJMC. Prior Authorization Panel Yields Insights Into Role of PBMs in Biosimilar Uptake. March 9, 2022. Mary Caffrey. https://www.centerforbiosimilars.com/view/prior-authorization-panel-yields-insights-into-role-of-pbms-in-biosimilar-uptake.
• Healthcare Dive. Medical groups say prior authorization burdens persisted during pandemic. March 8, 2022. Susan Kelly. https://www.healthcaredive.com/news/medical-groups-prior-authorization-burdens-pandemic/619980/.
• HealthExec. Prior authorization burdens are increasing. March 7, 2022. Amy Baxter. https://healthexec.com/topics/healthcare-management/healthcare-quality/prior-authorization-burdens-are-increasing.
• American Medical Association. Opinion: I’m used to my patients’ prior auth hassles. Then came Mom’s. March 4, 2022. Gerald E. Harman, M.D. https://www.ama-assn.org/about/leadership/i-m-used-my-patients-prior-auth-hassles-then-came-mom-s.
• Medical Economics. Prior auths not improving despite payer promises. March 4, 2022. Todd Shryock. https://www.medicaleconomics.com/view/prior-auths-not-improving-despite-payer-promises.

February 2022

• The Detroit News. Opinion: Remove bureaucratic barriers between patients and needed surgery. February 27, 2022. George Williams. https://www.detroitnews.com/story/opinion/2022/02/28/congress-should-remove-prior-authorization-barriers-care-cataract-surgery-insurance/6940664001/.
• American Medical Association. Why prior authorization is bad for patients and bad for business. February 18, 2022. Andis Robeznieks. https://www.ama-assn.org/practice-management/sustainability/why-prior-authorization-bad-patients-and-bad-business.
• Medpage Today. A Third of Docs Saw a Patient Harmed by Prior Authorization. February 11, 2022. Shannon Firth. https://www.medpagetoday.com/practicemanagement/practicemanagement/97167.
• U.S. Senator Roger Marshall. Press Release: Sen. Marshall Responds to New Data Showing Congress Needs to Put Patients over Paperwork. February 11, 2022. https://www.marshall.senate.gov/newsroom/press-releases/sen-marshall-responds-to-new-data-showing-congress-needs-to-put-patients-over-paperwork/.
• Revcycle Intelligence. AMA: Prior Authorization Creates Physician Burden, Patient Care Delays. February 11, 2022. Victoria Bailey. https://revcycleintelligence.com/news/ama-prior-authorization-creates-physician-burden-patient-care-de.
• U.S. Congresswoman Suzan DelBene. Press Release: New Data Underscores Need to Reform Prior Authorization, Improve Care for Seniors. February 10, 2022. https://delbene.house.gov/news/documentsingle.aspx?DocumentID=3044.
• American Hospital Association. AHA Comments to House Republican Task Force on Affordability. February 4, 2022. https://www.aha.org/lettercomment/2022-02-04-aha-comments-house-republican-task-force-affordability.
• U.S. Senator Roger Marshall. Press Release: Sen. Marshall Prior Authorization Legislation Gaining Momentum with 17 Cosponsors and 450 Supporting Organizations. February 2, 2022. https://www.marshall.senate.gov/newsroom/press-releases/sen-marshall-prior-authorization-legislation-gaining-momentum-with-17-cosponsors-and-450-supporting-orgnizations/.

January 2022

• Advisory Board. To get insulin, this journalist needed ’17 days and 20 phone calls’. January 26, 2022. https://www.advisory.com/daily-briefing/2022/01/26/prior-authorization.
• Kaiser Health News. Opinion: I Write About America’s Absurd Health Care System. Then I Got Caught Up in It. January 25, 2022. Bram Sable-Smith. https://khn.org/news/article/health-journalist-saga-insulin-access-complicated-insurance-system/.
• HER Intelligence. ONC Calls for Input on Electronic Prior Authorization Data Standards. January 24, 2022. Hannah Nelson. https://ehrintelligence.com/news/onc-calls-for-input-on-electronic-prior-authorization-data-standards.
• Healio News. Q&A: Prior authorization policy for cataract surgery results in costly delays to care. January 24, 2022. https://www.healio.com/news/ophthalmology/20220124/qa-prior-authorization-policy-for-cataract-surgery-results-in-costly-delays-to-care.
• HomeCare Magazine. Legislation That Made 2021. January 4, 2022. Kristin Easterling. https://www.homecaremag.com/january-2022/legislation-that-made-2021.

November – December 2021

• Fiercehealthcare. Industry Voices—How prior authorization can disrupt medically necessary care. December 20, 2021. Terry Wilcox. https://www.fiercehealthcare.com/payer/industry-voices-how-prior-authorization-can-disrupt-medically-necessary-care.
• The Columbus Dispatch. Doctors: Aetna has thrown up barriers to sight-saving surgeries. November 30, 2021. Alice Epitropoulos and Megan Chambers. https://www.dispatch.com/story/opinion/columns/guest/2021/11/30/opinion-insurance-company-policy-denies-patients-sight-saving-surgery/8785512002/.
• Medscape. Did Prior Authorization Refusals Lead to This Patient’s Death? November 24, 2021. Lola Butcher. https://www.regrelief.org/wp-content/uploads/2021/11/963627_print.pdf.
• NJ.com. Opinion: Eye doctor: Aetna is delaying and denying sight-restoring surgery for thousands. November 16, 2021. Ravi Goel, MD. https://www.nj.com/opinion/2021/11/eye-doctor-aetna-is-delaying-and-denying-sight-restoring-surgery-for-thousands-opinion.html.
• Healio News. AAO, ASCRS warn of prior authorization, step therapy restrictions in open enrollment. November 2, 2021. https://www.healio.com/news/ophthalmology/20211102/aao-ascrs-warn-of-prior-authorization-step-therapy-restrictions-in-open-enrollment.
• American Academy of Ophthalmology. It’s Medicare Open Enrollment Time: Beware of Plan Restrictions That Limit Access to Sight-Saving Care. November 1, 2021. https://www.aao.org/newsroom/news-releases/detail/medicare-open-enrollment-time.

October 2021

• American Association of Neurological Surgeons Congress of Neurological Surgeons. Washington Committee for Neurological Surgery. Neurosurgeons Applaud Senate Letter to CMS Calling for Improvements to Prior Authorization Process. October 28, 2021. https://www.regrelief.org/wp-content/uploads/2021/10/AANS-CNS-Release-Prior-Authorization-Senate-Letter-102821.pdf.
• U.S. Senator Sherrod Brown. Press Release: Brown, Thune Push Biden-Harris Administration to Adopt Bipartisan Plan to Improve Prior Authorization in Medicare Advantage Plans. October 28, 2021. https://www.brown.senate.gov/newsroom/press/release/brown-thune-prior-authorization-medicare.
• Richmond Times-Dispatch. Aetna’s cataract policy reflects how insurer approval has blurred patient care. October 26, 2021. Donna D. Brown, Thomas S. Carothers and E. Winston Trice. https://richmond.com/opinion/columnists/donna-d-brown-thomas-s-carothers-and-e-winston-trice-column-aetnas-cataract-policy-reflects/article_c3adfc0f-97c1-5743-b1cb-42236943bf01.html#tncms-source=login.
• Mad City News. Bill aiming to streamline MA prior authorization gains House majority support. October 26, 2021. Anuja Vaidya. https://medcitynews.com/2021/10/bill-aiming-to-streamline-ma-prior-authorization-gains-house-majority-support/.
• Policy & Medicine. Senate Introduces Bipartisan Prior Authorization Legislation: Timely Access to Care Act. October 25, 2021. Thomas Sullivan. https://www.policymed.com/2021/10/senate-introduces-bipartisan-prior-authorization-legislation.html.
• U.S. Senator Roger Marshall. Marshall, Sinema, and Thune Introduce Legislation to Put Patients over Paperwork. October 20, 2021. https://www.marshall.senate.gov/newsroom/press-releases/marshall-legislation-to-put-patients-over-paperwork/.
• Regulatory Relief Coalition. Coalition Applauds Senate for Introduction of Prior Auth. Reform Legislation. October 20, 2021. https://www.regrelief.org/wp-content/uploads/2021/10/RRC-PRESS.-SENATE-INTRODUCTION-D0971077.pdf.
• American Hospital Association. AHA Urges CMS to Address Prior Authorization Issues Affecting Medicare Advantage Patients. October 18, 2021. https://www.aha.org/lettercomment/2021-10-18-aha-urges-cms-address-prior-authorization-issues-affecting-medicare.
• Radiology Business. Radiologist-backed legislative push to rein in onerous prior authorization policies gains steam. October 15, 2021. Marty Stempniak. https://www.radiologybusiness.com/topics/healthcare-policy/radiologist-prior-authorization-insurance-congress.
• Regulatory Relief Coalition. Prior Authorization Relief Bill Reaches Significant Milestone. October 8, 2021. https://www.regrelief.org/wp-content/uploads/2021/10/H.R.-3173-Over-218-Milestone-Press-Release-D0968846.pdf.
• U.S. Congresswoman Suzan DelBene. Press Release: Legislation to Streamline Care and Reform Health Insurance for Seniors Reaches Bipartisan House Majority. October 8, 2021. https://delbene.house.gov/news/documentsingle.aspx?DocumentID=2973.
• Regulatory Relief Coalition. Neurosurgeons Enthusiastic About Progress of Legislation to Streamline Prior Authorization in Medicare. October 8, 2022. https://www.regrelief.org/wp-content/uploads/2021/10/AANS-CNS-Release-Prior-Authorization-Legislation-100821.pdf.
• American Medical Association. Physicians call on Congress to address prior authorization reform. May 14, 2021. https://www.ama-assn.org/press-center/press-releases/physicians-call-congress-address-prior-authorization-reform.
• Premier. Press Release: Premier Supports the Improving Seniors’ Timely Access to Care Act. May 13, 2021. https://www.premierinc.com/newsroom/policy/premier-supports-the-improving-seniors-timely-access-to-care-act.
• U.S. Congresswoman Suzan DelBene. Press Release: DelBene, Kelly, Bera, Bucshon Introduce Bipartisan Legislation to Make Care More Efficient for Seniors by Reforming Prior Authorization. May 13, 2021. https://delbene.house.gov/news/documentsingle.aspx?DocumentID=2809.
• Regulatory Relief Coalition. Leading Medical Specialty Coalition Welcomes Reintroduction of Prior Authorization Relief Bill (H.R. 3173). May 13, 2021 https://www.regrelief.org/wp-content/uploads/2021/05/RRC-FINAL-PRESS-RELEASE-HOUSE-BILL-INTRO-D0948815.pdf.