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. 2024 Dec;22(12):2362-2366.
doi: 10.1016/j.cgh.2024.09.001. Epub 2024 Sep 18.

An Overview of the Challenging Process of Prior Authorization: Medical Necessity for a Better Way

Stephen T Amann  1 , Eric D Shah  2 , Louis J Wilson  3
Affiliations

An Overview of the Challenging Process of Prior Authorization: Medical Necessity for a Better Way

Stephen T Amann et al. Clin Gastroenterol Hepatol. 2024 Dec.
No abstract available

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Conflict of interest statement

Conflicts of interest

These authors disclose the following: Stephen T. Amann has been ad hoc consultant for Eli Lilly. Eric D. Shah consulted for Ardelyx, Mahana, Mylan, Neuraxis, Sanofi, Salix, and Takeda. The remaining author discloses no conflicts.

References

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    1. Brot-Goldberg ZC, Burn S, Layton T, et al. Rationing medicine through bureaucracy: authorization restrictions in Medicare. Cambridge, MA: National Bureau of Economic Research, January 2023. Available at: https://www.nber.org/papers/w30878. Accessed February 18, 2024.
    1. Kyle MA, Song Z. The consequences and future of prior-authorization reform. N Engl J Med 2023;389:291–293. - PMC - PubMed
    1. Shah ED, Amann ST, Hobley J, et al. 2021 National Survey on Prior Authorization Burden and Its Impact on Gastroenterology Practice: ACG Prior Authorization Survey. Am J Gastroenterol 2022;117:802–805. - PMC - PubMed
    1. Grimm CA. Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care. OEI-09-18-00260. Available at: https://oig.hhs.gov/oei/reports/OEI-09-18-00260.asp. Accessed February 21, 2024.

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