MMA Viewpoint
The Absurdity of Preauthorization
I was listening to the concerns of several friends and thought of a great idea for this month’s column: preauthorization. So I approached the director of communications at the MMA, who told me she thought it was a good idea but that it was not her role to approve it.
Not to be discouraged, I asked the MMA’s CEO if he approved. Interestingly, he said he felt it was an acceptable and timely topic for this column but informed me that the magazine’s editors made those decisions and it was not within his authority to grant the approval.
Well, I didn’t get to where I am by being a quitter, so I contacted the editors of Minnesota Medicine. I was informed that all I had to do was submit, in triplicate, my rough draft and a brief note with the reasons why my idea should be approved, provided that all the paperwork was in order and my reasons satisfied at least three of their 10 criteria, which they then told me were proprietary. So I waited, hoping I had met their criteria and that an answer would come in time for me to meet my deadline.
It wasn’t really necessary to go through this convoluted process. I was illustrating some of the silliness that we physicians experience when we order imaging tests or write a prescription.
My primary care colleagues have recently expressed concerns about having to seek preauthorization when prescribing medications their patients have been taking for years, not just new, expensive ones.
Seeking permission from insurance companies is not only ridiculous, it takes time—time that physicians and other staff could spend with patients. It also adds to our overhead costs. Like many clinics, ours has a person assigned to make the calls and fill out the forms.
For the last year, the MMA has been dealing with the issue of physicians needing preauthorization for high-tech imaging, arguing that it wastes time for us and our patients. The MMA has called for an end to the requirement that physicians go through utilization review with a third-party vendor before ordering imaging procedures such as CT, MRI, and PET scans.
Reducing administrative headaches is one of the many things that your MMA staff, committees, lobbyists, AMA delegation, and board do on your behalf.
When your colleagues ask what the MMA is doing for them, one thing you can point to is our efforts to put limits on preauthorization. With your support, we will continue to be a voice at the local, state, and national levels for medicine and our members.
Spring is coming and so are opportunities to improve the practice of medicine.