States are Stepping Up Efforts to Curb Prior Authorization Abuses

Prior authorization requirements by insurers has plagued providers and patients for years and it seems to only be getting worse and Federal government has been unable to move anything of real substance. Due to this inaction, about half of the states have implemented legislation to limit prior authorizations. For instance, New Jersey set a 72-hour deadline on most claims, Texas has a "gold card" system that exempts physicians with a 90 percent approval rate, and Michigan mandates peer-reviewed criteria for prior authorization. For more on what states are doing, click here.