AMA House of Delegates News: ASNC Delegates Support New Prior Authorization Reform Policies

At this month's American Medical Association House of Delegates (HOD) virtual annual meeting, ASNC Delegates Saurabh Malhotra, MD, MPH, FASNC, and Nishant Shah, MD, FASNC, voted to support new efforts to rein in prior authorization requirements.

Adopted on June 15, the new policies focus on the peer-to-peer (P2P) review process and call for – 

  • All P2P prior authorization decisions to be made actionable within 24 hours of review;
  • P2P reviewing physicians to have clinical expertise to treat the medical condition or disease under review;
  • P2P reviewers to follow evidence-based guidelines consistent with national medical society guidelines, such as ASNC's; and
  • Prior authorization requirements to be suspended during a declared public health emergency such as COVID-19.

“Prior authorization requirements have a number of negative effects on our patients and our labs,” says Dr. Malhotra. “These requirements disrupt efficiency, potentially impacting patient satisfaction. More troubling are the data showing how prior authorization can lead to care delays and treatment abandonment. These new policies are important because they will result in care that is more timely and more respectful of clinicians' judgment and patients' preferences. As a PatientFirst Imaging society, ASNC will continue working with the AMA and other organizations to reduce prior authorization burdens and ensure test-selection decisions are made by clinicians and their patients."    

More Prior Authorization News 

This is not the first time ASNC has worked to reduce the prior authorization burdens that members face. ASNC's health policy team is currently supporting the Improving Seniors' Timely Access to Care Act” (H.R. 3173). Introduced in May, this bipartisan legislation would protect patients from unnecessary delays in care by streamlining and standardizing prior authorization under Medicare Advantage plans. Stay tuned for updates.