The top thing I like about the Member of Congress I’m working with (older though not geriatric age woman) is she knows her issue areas cold. Including one that is highly technical ( #kidney disease). Absolutely could do a “chalk talk” on #priorauth or #Medicare compensation of ESRD

I get it, #academicmedicine feels like a scam sometimes. my dudes, I may be writing a bill next week to prevent CMS enrolling #olderadults in #MedicareAdvantage without their consent and be forced into #priorauth
This affects clinical practice far more than Journal of 5 people read in last 20 years

My boss in the #House of Representatives is big in the (anti) #priorauth space, so I just sent this as an SOS #policy emergency at 9 PM on a Friday to my poor #health #legislative advisor lol - sounds like it would require #Congressional approval, so we may be drafting a bill to block this Monday AM

Two people are engaged in conversation, sitting inside a room. One person is seen from behind, wearing a white coat, listening attentively. The other person is gesturing with their hands while speaking.

Our latest #research polling reveals the challenges patients face with #PriorAuthorization. Most Americans with a #ChronicIllness needed #PriorAuth in the past year, with 41% requiring it multiple times.

Dive deeper into our findings: https://bit.ly/409XSKM

#MedSky #ChronicIllness

#HealthSpending #HealthSpendingGrowth #SiteNeutral #PriorAuth #HealthAI #PreventiveCare

my tipping point after paying the amount of money I have for yrs for diseases “They” caused us to have. I don't know about you but I would love to be back on our timeline this isn't it. #1stCrashOut2026 #PriorAuth #Insurance #Government #PrescriptionDiscountCard

Medicare prior authorizations off to a rocky start, providers say The Wasteful and Inappropriate Service Reduction Model, or WISeR, is meant to root out wasteful spending in fee-for-service Medicare.

CMS WISeR Model, launched 1/1/26, imposes #Al-driven #priorauth into Medicare.

Big rollout challenges:

-vague confusing guidelines
-increased admin burdens on providers
-concerns over automated denials. -fears that $ incentives for contractors may cut patient access to care

tinyurl.com/2p9swyk5

An individual stands next to a message urging Congress not to let prior authorization hinder patient treatment, with a prompt to contact lawmakers today.

55% of adults aged 65+ report that they had to obtain #PriorAuth before receiving a treatment within the past 2 years (@kff.org, 2025).

H.R. 3514/S. 1816 aims to modernize PA with electronic processes, transparency, & accountability. Ask #Congress to support this legislation: https://bit.ly/45M3SwL

We in #healthpolicy are thankful Trump neither understands nor gives even half a shit about #healthcare because we actually can somewhat try to do some productive stuff in Congress (we are working on an anti- #priorauth bill with 200+ cosponsors)
My #trade and #foreignpolicy comrade is not so lucky

BILL NUMBER: A9407 PURPOSE OR GENERAL IDEA OF BILL: To prohibit prior authorization for oncology care which has previously been authorized and complies with National Comprehensive Cancer Network (NCCN) guidelines with Categories of Evidence and Consensus 1 or 2A as evidence-based standards of care.

Proud of the New York State Assembly for introducing this bill which bans #priorAuth for any cancer rx w/ a NCCN level 1 or 2A rec. This would be a meaningful step to #FixPriorAuth. 💊 ☢️

#PriorAuthorization: "it's just wasting people's time"

nyassembly.gov/leg/?default...
@ascocancer.bsky.social

Yeah it was a good productive week for #healthcare thanks for the tireless efforts of Rep. Underwood’s office.
(The congresswoman I’m working with is focused on getting #priorauth out of #Medicare, also important, hope to get that across the finish line while I’m here too)

I told my parents at #birthday dinner today of serious plans to look outside US to practice #medicine.
No #priorauth, no #insurance, no ban on critical #healthcare staffing like #doctors and #nurses that courts are totally ok cuz they want an all white country with immense preventable death

#AI #HealthInsurance #PriorAuthorization #AIHealth #AIHealthcare #AIHealthInsurance #InsuranceDenial #PriorAuth

AMA: AI-driven coverage decisions MUST disclose criteria, validation, risks. Patients deserve transparency.

Read: tinyurl.com/3ptpu93k
Read: tinyurl.com/mz95ah4
Click: tinyurl.com/ybwy9jhj

#AMA #AIethics #PriorAuth

Prior Authorization Is Burdensome for Patients, Resulting in Treatment Delays, Financial Strain, and Stress “This study makes clear what many of us in oncology have suspected: Prior authorization isn’t just an administrative hurdle for clinicians; it’s a hidden second job for patients,” noted investigators....

“Cancer pts & their families are being pulled into the #priorauthorization process, at the expense of their time, health, & well-being”
 
#Priorauth isn’t just an administrative hurdle for clinicians; it’s a hidden 2nd job for patients. #ascoQLTY25

@ascocancer.bsky.social
@ascopost.bsky.social

AI Prior Authorization Automation in Healthcare

staffingly.com/ai-prior-aut...

#PriorAuthorization #HealthcareAI #MedicalBilling, #HealthcareAutomation #VirtualMedicalAssistant #PriorAuth

As Insurers Pledge Prior Authorization Reform, Here’s How Automation Can Help Providers Keep Pace #PriorAuth #HealthIT
www.healthcareittoday.com/?p=2526655

Instead of the Virgin Suicides, we'll have the #Geriatrician suicides. (black humor but also not - we love seeing patients, but #priorauth and #insurance companies consuming 80% of our time causes significant burnout, the fact we'll be battling a data center instead of a human...won't help)

Agents Knew Our Specialty No More Explaining Terms Twice

staffingly.com/agents-knew-...

#HealthcareAI #VirtualAgents #HealthTech #ClinicalSupport #PriorAuth #MedicalBilling #DigitalHealth #OperationalExcellence #Staffingly

Patient Perspectives on Prior Authorization for Cancer Care This qualitative study characterizes the perspectives of patients with cancer regarding their experience with prior authorization for cancer care.

🗣️"The system is horribly broken & it hurts patients unnecessarily”
🗣️"They wrote me off as a dead man”
 
Navigating #priorauth requires tech savvy, an understanding of insurance processes, knowledge of personal rights, & time to engage in the process.
 
@ascocancer.bsky.social @astro-org.bsky.social

Beyond the Rules Engine: How Agentic AI Is Helping Health Plans Solve Prior Authorization #priorauth #HealthIT
www.healthcareittoday.com/?p=2525023

Availity is Already Automating Prior Auths #PriorAuth #RCM #HFMAAnnual
www.healthcareittoday.com/?p=2524559

#OBBBA also undermines bipartisan state progress to increase affordability and accessibility of care thru diabetes coverage requirements, limits on cost sharing, and #priorauth reforms, as attention/funding turn to responding to the mess #OBBBA will cause the individaul market.

How to Effectively Appeal Denials in Prior Authorization Struggling with prior authorization denials? Learn how smarter strategies and expert support can turn them into fast approvals—and save time, money, and care.

Struggling with #priorauth denials? Learn how smarter strategies and expert support can turn them into fast approvals—and save time, money, and care. Learn more at sunknowledge.com/how-to-effec...

staffingly.com/patient-jour...

Patient Journey Through Eligibility Checks and Prior Authorization: Wegovy and Zepound

#PriorAuth #Wegovy #Zepbound #GLP1Support #InsuranceVerification #ZappyHealth #VirtualCare #WeightLossMedications

This will literally kill people. My wife's kidney cancer bone met was not picked up on X-rays. An ortho suspected rotator cuff tear but ordered MRI to be sure. Surprise - 4cm lesion & a full shoulder replacement. According to doc without Medicare it would have been months of delay. No #priorAuth!

CMS Launches New Model to Target Wasteful, Inappropriate Services in Original Medicare | CMS Model will leverage enhanced technologies to protect Medicare beneficiaries, federal taxpayers from unnecessary services, fraud, waste, and abuse

🚨CMS just announced a model to introduce new #priorauthorization barriers to Traditional Medicare (which classically hasn't faced any).

We need less #priorAuth, not more.

Don't let this title fool you.
This is a "fix" for a problem that doesn't exist.
@ascocancer.bsky.social
@astro-org.bsky.social

Two women taking a selfie while smiling in the door of an elevator bc we forgot to take a photo in a more picturesque setting

Love academic meetings for catch up sessions with my amazing friends & collaborators. Dr @lghazal.bsky.social gave an important talk at #mascc25 on #financiaToxicity in #ayacsm. We do a tonne of research together about #priorAuth & healthy policy gaps. But we also just like to hang out. 😘

Understanding the Key Differences among Prior Authorization, Reauthorization, Predetermination, and Retroactive Authorization Confused by prior authorization, reauth, or predetermination? Our experts simplify it all. Boost approvals and cut delays. Learn more now!

Confused by #priorauth, reauth, or predetermination? Our experts simplify it all. Boost approvals & cut delays. Learn more now! Learn more at sunknowledge.com/key-differen...

THE HEALTH INSURANCE MAZE How Cancer Patients Get Lost in the Red Tape of Utilization Management

Key Report Themes CANCERCATE Over 80 Years ef Help and Hope • Prior authorization is widespread and repetitive • Prior authorization leads to time burdens and care delays • Coverage stoppages surprise patients and interrupt care • Insurance problems affect stress, health, finances, and trust • Self-advocacy barriers include gaps in insurance literacy and system awareness • Employer-sponsored plans carried highest administrative burdens, followed by Medicare Advantage, then Traditional Medicare

Needed At Least One Prior Authorization for Cancer Treatment, Past 12 Months, by Insurance Type

"It is a nightmare waking up every day wondering if some people halfway across the country will approve what my doctors have said is my only chance."

📄 New #PriorAuth in cancer report shows the scope of the problem & the need to #fixpriorAuth @cancercare.bsky.social

www.cancercare.org/redtape