NY Times 3/14/24: ‘What’s My Life Worth?’ The Big Business of Denying Medical Care

Some of the input from this video was from physicians in our ImproveCareNow consortium (personal communication). Here’s an key points/excerpt: Prior Authorization Video (8:37 minute video)

• This video explains how insurance companies have ‘weaponized’ prior authorization to postpone and/or deny care in order to increase their profits. “This is medical injustice disguised as paperwork.”
• The video states that ~80% of PAs are effective in preventing patients from getting the care their physician recommended. However, when physicians spend their time appealing denials, they are usually successful in getting the medication covered.
• “Prior authorization gives your insurance company more power than your doctor.”
• There are efforts in Congress, including the GOLD Card Act of 2023, aimed at reforming prior authorization.

My take: Prior authorization delays and denials of care sometimes have devastating consequences (watch the video)

Related blog posts:

• The Consequences of Prior Authorizations
• “Denials, Dilly-dallying and Despair”
• What’s Changing in IBD Care: Hospitalization Rates and Authorizations
• High Rates of Denying Medical Care for Medicaid Patients Managed by Health Insurers
• What’s Wrong with Step Therapy Reform: Safe Step Act
• “We Need More Information to Process This Claim”