From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places when we believe they hit the mark on an issue. Today’s post originally appeared in The American Spectator on April 29, 2021. In the op-ed, Richard Menger, MD, MPA, assistant professor of neurosurgery and political science at the University of South Alabama in Mobile, Ala. discusses the recent Centers for Medicare & Medicaid Services (CMS) announcement to begin prior authorization for specific procedures, including spine surgery, starting July 1. Insurance companies currently use prior authorization to limit the services they provide for their customers.
According to Dr. Menger, “The prior-authorization process does not serve as a national guidelines-based quality control process to ensure local physicians adhere to stringent medical standards. Rather, it serves as opaque obfuscation and deterrence.” Prior authorization is generally not driven by scientific data. It delays care and serves as an obstacle to medically necessary patient care, disrupting the patient-physician relationship.
Editor’s Note: We hope that you will share what you learn from our posts. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtag #FixPriorAuth.