Accelerate industry adoption of national electronic standards for prior authorization and improve transparency of formulary information and coverage restrictions at the point-of-care.
This group of health care leaders is committed to ongoing collaboration to improve the prior authorization process for health care professionals, health insurance providers, and, most importantly, patients. As experience is gained, these processes will be further refined to maximize efficiency and minimize care disruption for patients.

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Association Quotes:

American Hospital Association
“America’s hospitals and health systems are committed to delivering the best care for patients in the most efficient manner, goals we share with our partners in the health field,” said Tom Nickels, executive vice president of the AHA. “These principles provide a good starting point for providers and health plans to work together toward continuous improvement in quality of care and health outcomes while reducing unnecessary administrative burden.”

America’s Health Insurance Plans
“Working together, we can find the right solutions to improve the process, promote quality and affordable health care, and reduce unnecessary burden,” said Richard Bankowitz, M.D., chief medical officer of AHIP.

American Medical Association
“This collaboration among health care professionals and health plans represents a good initial step toward reducing prior authorization burdens for all industry stakeholders and ensuring patients have timely access to optimal care and treatment,” said AMA Chair-elect Jack Resneck, Jr., M.D.

American Pharmacists Association
“We are very supportive of this collaborative effort that is critical to improving patients’ access to needed medical services and medications, promoting continuity of care, and removing provider burdens. Adoption of these principles will free physicians, pharmacists, and others to spend more time in patient care,” said Thomas E. Menighan, EVP & CEO of the APhA.

Blue Cross Blue Shield Association
“By working together, we’re taking an important step forward in alleviating what can be an unnecessary burden for some patients, while ensuring our members continue to receive high quality, safe and effective care,” said Justine Handelman, senior vice president of policy and representation at Blue Cross Blue Shield Association.

Medical Group Management Association
“By forging an agreement addressing an important set of prior authorization challenges, this collaborative is leading the industry toward the dual aim of reducing the volume of required authorizations and decreasing complexity in conducting these transactions,” stated Anders Gilberg, MGMA senior vice president, government affairs.

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