Exclusive: Dr. Oz announces health coalition to streamline prior authorizations
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Dr. Oz speaks at Axios' Future of Health Summit on May 13.
A coalition of 29 major health care players is coming together to simplify the prior authorization process for medical treatments, Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, announced at Axios' Future of Health Summit Wednesday.
The big picture: Last summer, several top health insurers voluntary pledged to streamline and improve the prior authorization process across all health insurance markets.
Driving the news: "The payers, the insurance companies, have been playing ball. Guess who's not been playing ball until today? The providers," Oz told Axios' Caitlin Owens.
- The new coalition includes insurers, hospitals and health records companies to streamline the process for reviewing medical procedures, known as prior authorization.
- Prior authorizations can help control health care spending, but they can also discourage patients from treatment and burden providers.
Zoom in: AtlantiCare, Bon Secours Mercy Health and Cleveland Clinic are among the groups joining the push.
- "If everyone can get access to the information they need ... by next January, there will be some settings where you will have a prior auth done, and you will not know what happened," Oz said.
Catch up quick: Earlier this month, Oz wrote in a blog post that it's "way past time to axe the fax, kill the clipboard, and put patients over paperwork" via electronic prior authorization.
- Medicare began AI-powered pre-treatment reviews for certain health services in an effort to root out unnecessary care in a handful of states earlier this year, unnerving doctors.
- Traditional Medicare historically hasn't required prior authorization for most drugs or services, but the process became a hot-button issue in privately run Medicare Advantage plans over the administrative headache it caused doctors.
Zoom out: Health insurers say they've cut pre-treatment claim reviews by 11% in the past year after pledging to streamline requirements, Axios previously reported.
- But patient advocates have still pushed for new laws and regulations addressing prior authorization, Axios' Maya Goldman writes.
- There's support in Congress for limiting prior authorizations for Medicare Advantage, though that effort has stalled.
Go deeper: Dr. Oz: AI and robots can already provide medical care
