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Prior Authorization

Prior authorization puts a large administrative burden on physicians. AWIR supports uniformed prior authorization legislation that: (1) requires insurers to use the uniform prior authorization form, adopted by the Department of Insurance, for prescription medications, medical treatments and procedures; (2) requires the form to be electronically accessible and able to be submitted electronically; (3) deem authorization granted if an insurer fails to respond to or accept the uniform prior authorization form within 5 business days or, for urgent requests, 1 business day upon receipt of a request.

Improving Seniors Timely Access to Care Act HR3107 — Standardizes the use of prior authorization in Medicare Advantage (MA) plans by establishing a streamlined and transparent electronic transmission process for submitting prior authorization requests.