New MGMA Poll Shows Prior Authorization on the Rise Despite COVID-19 Pandemic

“Despite a modest reprieve from certain health plan prior authorization requirements during the first few months of the pandemic, medical groups report a significant spike in prior authorization requirements since 2020,” said Anders Gilberg, MGMA SVP of Government Affairs. “In addition to the sharp rise in prior authorization demands, practices report increased denials, delayed approvals for care, and constantly changing rules.”

MGMA has long advocated for health plans to reduce the magnitude of PA demands on medical practices, implement standardized electronic processes, and increase transparency of authorization rules. In a 2018 industry consensus statement, industry groups agreed on several areas of meaningful reform. Unfortunately, this new data reflects little progress on the agreement to date.

MGMA additionally supports the reintroduction of the Improving Seniors’ Timely Access to Care Act (H.R. 3173), which would enact prior authorization rules for Medicare Advantage plans, consistent with the 2018 agreement.

This article was shared with Prittle Prattle News as a Press Release by PRNewswire.

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