Prior Authorization

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Transforming Prior Authorization to Decision Support.

PURPOSE To evaluate a computer-based prior authorization system that was designed to include and test two new concepts for physician review: (1) the tool would minimize denials by providing real-time decision support with alternative options if the original request was noncompliant, and (2) the tool would collect sufficient information to create a patient registry. METHODS A new prior authori...

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Are Insurers' Prior Authorization Rules Killing Opioid Addicts?

The results can be tragic. Patients with addictions are unlikely to wait the hours or days it takes health insurers to approve the medications they need. Insurers are changing their practices, but not without some outside pressure.

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Prior Authorization On Angiotensin - Receptor Blockers : Can Policy

Prescription drug cost containment is a key health policy priority. State Medicaid programs have implemented policies requiring prior authorization before paying for angiotensin-receptor blockers (ARBs), a costly class of blood pressure medications. We examined the impact of these policies on drug use. We found that policies using a steppedtherapy approach reduced ARB use by 1.6 percent when fi...

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Medicaid prior authorization policies and imprisonment among patients with schizophrenia.

OBJECTIVE To examine the impact of Medicaid prior authorization for atypical antipsychotics on the prevalence of schizophrenia among the prison population. Study DESIGN We collected drug-level information on prior authorization restrictions from Medicaid programs in 30 states to determine which states had prior authorization requirements before 2004. We linked the regulatory data to a survey ...

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A physician-friendly alternative to prior authorization for prescription drugs.

OBJECTIVE To determine if the instant approval (IA) process differs from the traditional prior authorization (PA) process in preferred drug channeling, resultant gaps in therapy, and provider dissatisfaction. STUDY DESIGN An interrupted time series analysis using pharmacy claims and a retrospective cohort study. METHODS The study assessed changes in preferred drug use and subsequent cost re...

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ژورنال

عنوان ژورنال: JACC: Clinical Electrophysiology

سال: 2020

ISSN: 2405-500X

DOI: 10.1016/j.jacep.2020.04.022