The Colorado Medical Society joined the American Medical Association and 103 other national, state and specialty organizations in a letter to the Centers for Medicare and Medicaid Services urging additional actions to address the burdens of prior authorization and warning against focusing on automation as the only vehicle for PA reforms.
The organizations urge five reforms to address the signification problems caused by PA:
- Selective application of PA to only “outliers;”
- Review/adjustment of PA lists to remove services/drugs that represent low-value PA;
- Transparency of PA requirements and their clinical basis to patients and physicians;
- Protections of patient continuity of care; and
- Automation to improve PA and process efficiency.
Among other concerns, exclusively relying on technology to address the burdens of PA – specifically with the Da Vinci Project, which leverages technology to facilitate electronic exchange of clinical data by extracting information from physicians’ electronic health records – could give payers “unprecedented access to EHRs” that could lead to them “inappropriately accessing patient information, coercing physicians into using technology (e.g., through contracts), or interfering with medical decision making.”Read the full letter here.