Since January 2014, primary care physicians have noticed an uptick in requests from Medicare Advantage and commercial health plans requiring medical prior authorizations for diagnostic and treatment services. These requests are a result of additional requirements from the health plans beyond the scope of usual and customary HMO authorization guidelines. In addition, each insurer has their own form and policies and procedures, which shift more of the burden on physicians resulting in increased work and reduced reimbursement.

A stakeholders committee has been formed to propose legislation that would streamline the process with one form and implement a more cohesive course of action by insurers.

Your input is extremely valuable as it will help us prepare our testimony and hopefully influence change.  

What are your thoughts on this issue?  

Please weigh in through our 5-minute survey: http://www.mcmsonline.com/medical-referral-prior-authorization