Prior authorization requires permission to be sought before prescribing critical drugs, which could cost lives, doctors say
In the midst of the worst overdose epidemic in US history, addiction medicine specialists say a bureaucratic hurdle is adding to the difficulty of getting people in treatment: an insurance industry tactic called “prior authorization”.
Loathed by doctors of all stripes, prior authorization requires healthcare providers to seek permission from insurance companies before they prescribe a treatment. Doctors in addiction medicine said the requirement is both unnecessarily burdensome and could cost lives.
“We have patients who are having overdoses once a month because of the fentanyl being in the drug supply,” said Dr Alain Litwin, a clinical researcher and executive director of the Prisma Health Addiction Medicine Center in South Carolina. “This is the crisis of our time – overdose rates are rising every year”.
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Prior authorization is especially harmful in one program: Medicaid. More than half of the people who received treatment for opioid use disorder in 2017 used the public health insurance program for the poor and disabled, according to the Kaiser Family Foundation.
Yikes. There are times when PA is fine, but not when your members need treatment for addiction!
I wonder insurance companies found it’s cheaper to let their opioid-addicted members OD and die…
Yeah I think you nailed the motive on this. Addiction probably impacts overall health which also drives up their costs for non addiction related coverage to the same people. Someone at the insurance company did the math on the money saved by people with addictions dying vs having to cover them for long term care.