February 22: Prior Authorization in Health Insurance: A Needed Tool to Contain Costs or an Excessive Barrier to Needed Care?Nearly 1 in 5 consumers with health insurance say their insurer delayed or denied care in the past year due to its requirements for prior authorization, a process through which insurers can require patients to obtain approval in advance before they will agree to cover specific services.
Insurers point to prior authorization as a tool to limit unnecessary and ineffective care, thereby reducing costs. However, the practice is also drawing increased scrutiny amid concerns that it creates unreasonable barriers to patients getting needed care and generates excessive paperwork burdens on doctors and other providers. Last month, federal regulators finalized new rules to govern how insurers use prior authorization in Medicare Advantage, Medicaid, the Children’s Health Insurance Program, and the Affordable Care Act’s federal Marketplace plans, while lawmakers are weighing potential broader legislation.
On Thursday, Feb. 22 at Noon ET, a panel of four experts will join Larry Levitt, KFF’s executive vice president for health policy, for a 45-minute discussion addressing the future of prior authorization requirements in health care. The panel will discuss why insurers use prior authorization, its impact on patients and providers, and how the new regulations may change current practices. They will also examine the potential for further regulatory or legislative actions to address ongoing concerns. Moderator
Panelists
KFF’s virtual Health Wonk Shop series features in-depth policy discussions with experts that go beyond the news headlines to provide greater insights.
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