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May 20, 2021: New MGMA Poll Shows Prior Authorization on the Rise Despite COVID-19 Pandemic

Advocacy Statement - May 20, 2021

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FOR IMMEDIATE RELEASE CONTACT: Chad Clinton
May 20, 2021 202.262.1067; cclinton@mgma.org

 
New MGMA Poll Shows Prior Authorization on the Rise Despite COVID-19 Pandemic

 
WASHINGTON, DC - In a new May 18, 2021 MGMA Stat poll, 81% of medical group practices reported that prior authorization (PA) requirements have increased since 2020.  Only 2% of respondents stated that PA requirements have decreased. 

“Despite a modest reprieve from certain health plan prior authorization requirements during the first few months of the pandemic, medical groups report a significant spike in prior authorization requirements since 2020,” said Anders Gilberg, MGMA SVP of Government Affairs. “In addition to the sharp rise in prior authorization demands, practices report increased denials, delayed approvals for care, and constantly changing rules.”

MGMA has long advocated for health plans to reduce the magnitude of PA demands on medical practices, implement standardized electronic processes, and increase transparency of authorization rules. In a 2018 industry consensus statement, industry groups agreed on several areas of meaningful reform. Unfortunately, this new data reflects little progress on the agreement to date.

MGMA additionally supports the reintroduction of the Improving Seniors’ Timely Access to Care Act (H.R. 3173), which would enact prior authorization rules for Medicare Advantage plans, consistent with the 2018 agreement.
 
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