The Private Payers Committee gave a brief update on Prior Authorizations at the February 4/21 ORA Town Hall. Uncertainties surround the criteria used to approve/reject prescribed therapeutics and I would ask members to provide redacted rejections along with the dates of application submissions and resolutions (were they successful resubmissions? Was therapy changed?). Please send examples to email@example.com. We want to get an estimate of the scope and magnitude and will track this and work towards an appropriate response from the ORA.
Members interested in participating in a subcommittee are welcome!