While radiation oncology faces the most prior authorization hurdles of any medical specialty, these problems stretch across the American health care system. An April 2022 report from the inspector general’s office of the Health and Human Services Department concluded that 13% of Medicare Advantage prior authorization requests, or about 85,000 beneficiaries, were improperly denied in 2019.
The Council for Affordable Quality Healthcare estimated that $686 million in spending was associated with conducting prior authorizations in 2021. A separate study calculated a $40 million annual financial impact for the time required to secure approvals at academic radiation oncology clinics.
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ABOUT ASTRO
The American Society for Radiation Oncology (ASTRO) is the largest radiation oncology society in the world, with nearly 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. For information on radiation therapy, visit RTAnswers.org. To learn more about ASTRO, visit our website and follow us on social media.
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