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Physicians, hospitals and patient groups back prior-authorization overhaul to reduce delays and administrative waste
Summary
Physician groups, hospitals and patient advocates told the Joint Committee S1403 would right-size prior authorization by requiring timeliness, continuity when patients change plans, mandated response windows for urgent requests and standardized electronic processes, arguing those changes preserve utilization review while removing harmful delays.
Medical societies, hospitals and patient advocates urged the Joint Committee on Health Care Financing to act on S1403, an act relative to reducing administrative burden that would reform prior authorization practices across insurers operating in Massachusetts.
Witnesses described prior authorization as a widespread administrative burden that delays care and contributes to clinician burnout. "The current prior authorization process is the complete opposite and based on little to no evidence," Lita Anderson of the Massachusetts Medical Society said, describing the issue as a major driver of administrative waste and clinician attrition.
Key proposals in S1403 include: - Requiring prior authorizations to remain valid for the duration of a course of treatment or for at least one year when clinically appropriate…
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