Prior Authorization Hell?
I found this recently online. I did not receive it so I couldn’t verify it but it looks like the letter is fake. It is way too realistic to be satire/parody as you would want to add some funny items like needing to send your firstborn or saying three Hail Marys before faxing. Whoever made it created something so believable that it had a lot of people fooled. That’s an indictment of how bad our system is or how much we hate prior authorizations.
From The State of Washington, Medical Commission. Sure enough, the cyberattacks on E-prescriptions have begun. State of Washington reminding physicians that paper prescriptions are still allowed under certain conditions.
Electronic Prescriptions and Cyberattacks
Olympia, WA – February 27, 2024.
Pharmacies nationwide, including some CVS stores, are facing ongoing delays filling prescriptions following a February 21, 2024 cyber-attack on a healthcare software provider. The provider systems are down for the seventh straight day after the cyber attack as of 10 a.m. February 27, 2024. The breach affected military clinics and hospitals worldwide. Doctors are likely to see an increased number of calls, upset patients, and delays. At this time, practitioners do have alternatives.
While RCW 69.50.312 requires that prescriptions for controlled substances be electronically communicated to a pharmacy, there is an exception to this requirement “when the electronic system used for the communication of prescription information is unavailable due to a temporary technological or electronic failure.” This would be a qualifying time under this section of law.
Practitioners should remember that paper prescriptions must be on tamper resistant prescription pads. In addition, the law states that a pharmacist who receives a written, oral, or faxed prescription is not required to verify that the prescription properly meets any exemptions under this section. Pharmacists may continue to dispense and deliver medications from otherwise valid written, oral, or faxed prescriptions.
Happy to chat about PA any time. With over 30 years in the Insurance biz, I can tell you that they are needed because some of our clinical colleagues are out of date, greedy, or bad in some other way. That’s not to say that some insurers abuse PA – but there are solutions.
Your “clinical colleagues”???
What the hell does that mean?
If PAs are needed, then docs need to be paid for their work doing them.
I’m sure during your time with insurers you didn’t do anything as unethical as stealing time, energy, and knowledge from practicing physicians?
Dear Doug: Here is the Macro I created and use in our electronic medical record to reply to patients who ask for Prior Authorizations for their medications. I recall reading you were a big fan of GoodRx too: “FRANK SAVORETTI JD MD, 2/27/2024 10:38:21 AM > I decline to submit to the tyranny of all health insurers requiring prior authorizations for more and more medications. Have suffered enough aggravation and wasted time and shall not tolerate it anymore. Suggest you download an App called GoodRx into your smartphone and price the cash price at local pharmacies, let me know which one you prefer and shall send future refills there.”
Awesome stuff!!
And maybe tell them about Cost Plus pharmacy. I’m no fan of Mark Cuban, but I can tell you I got 90 days of a med for the same price as 30 days at the pharmacy. UHC refused to cover it all.
I have been able to find a product where I can print out prior authorization forms on toilet paper. I can fill them out completely, wipe my bottom with them and flush and I have just as much success as filling out the regular prior authorization pathways. But this way I get something out of it.
If this is true I need to see it!!!