Deadly Denials

Designed to prevent doctors from deploying expensive, ineffectual procedures, prior authorization — sometimes called pre-authorization or pre-certification — has become a confusing maze used by health insurance companies that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. Proposed federal rules may not be enough to solve the problems.

Deadly Denials

Feds Move to Rein In Prior Authorization, a System That Harms and Frustrates Patients

The federal government wants to change the way health insurers use prior authorization — the requirement that patients get permission before undergoing treatment.

Deadly Denials

Doctors and Patients Try to Shame Insurers Online to Reverse Prior Authorization Denials

Frustrated by the process, patients and doctors have turned to social media to publicly shame insurance companies and elevate their prior authorization denials for further review.

Deadly Denials

Woman Petitions Health Insurer After Company Approves — Then Rejects — Her Infusions

Even people with good insurance aren't guaranteed affordable care, as this KFF Health News follow-up to one patient’s saga shows.

The Health 202

Will CMS Crack Down on Prior Authorization?

 

Deadly Denials

Cancer Patients Face Frightening Delays in Treatment Approvals

Delaying cancer treatment can be deadly — which makes the roadblock-riddled process that health insurers use to approve or deny care particularly daunting for oncology patients.

Hospitals and Doctors Are Fed up With Medicare Advantage

By Julie Appleby KFF Health News Original

Medicare Advantage plans are pretty popular with both lawmakers and ordinary Americans — they now enroll about 31 million people, representing just over half of everyone in Medicare, by KFF’s count. But among doctors and hospitals, it’s a different story. Across the country, provider grumbling about claim denials and onerous preapproval requirements by Advantage plans […]