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Prior authorization and regulations hindering delivery of care, say providers

by John R. Fischer, Senior Reporter | November 08, 2021

MGMA has submitted the results of its survey to Congress and the administration to help identify problematic regulations, improve existing programs and implement meaningful quality improvement efforts in Medicare. It is also supporting proposed bi-partisan legislation such as The Improving Seniors' Timely Access to Care Act in the hopes that such policies will reduce onerous insurer prior authorization requirements.

"Approximately 15% of healthcare spending in this country goes to costly administrative and regulatory processes," said Gilberg. "We need to significantly reduce this waste and reallocate precious healthcare resources to patient care."

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ASTRO recently backed a Congressional bill introduced in the Senate this month that, if passed, would reduce restrictive prior authorization practices that delay patient access to critical cancer treatments. "Prior authorization is not achieving its intended goal of improving efficiency and quality in American health care,” said Dr. Thomas Eichler, FASTRO, chair of the ASTRO board of directors. “Instead, the broken system causes our patients immense anxiety, undermines physicians' clinical judgment, and drains resources from clinics struggling to recover from the pandemic."

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