Prior Authorization

The American College of Rheumatology has released a position statement advocating for sweeping changes to the current system of prior authorization, including reducing the number of rheumatologists and rheumatology professionals subject to the controversial practice.

Researchers at Harvard Medical School’s Center for Primary Care are tackling some of the biggest issues in the field — limited resources, reimbursement and burnout — both in the United States and abroad.

How can a system that a) incentivizes higher drug prices; b) steers patients to drugs that make the most money for the middleman; c) creates god-knows how many different step therapy regimens subject to change at any time, and; d) actually fosters monopolies of certain drugs that are very expensive, be perfectly legal?

Prior authorization requirements are associated with delays in treatment, with denials linked to greater glucocorticoid exposure for patients, according to data published in Arthritis Care & Research.

GRAND RAPIDS, Mich. — As infusion centers have grown in complexity throughout the years, so too has the patient experience in these suites, with individuals often asked to take on a greater understanding of the clinical and financial impacts of their treatment, according to a presenter at the National Organization of Rheumatology Managers Annual Conference.

The American College of Rheumatology has joined 369 other patient, physician and health care professional groups in calling on Congress to pass a bipartisan bill that would amend the Social Security Act to regulate the use of prior authorization for patients with Medicare Advantage plans.

High drug costs and regulations requiring prior authorization of treatment plans are barriers to cancer treatment that can affect clinical outcomes for patients, according to results of two studies scheduled for presentation at Quality Care Symposium.