{"id":611873,"date":"2024-02-22T15:38:32","date_gmt":"2024-02-22T20:38:32","guid":{"rendered":"https:\/\/www.kff.org\/?post_type=event&#038;p=611873"},"modified":"2025-08-09T06:51:45","modified_gmt":"2025-08-09T10:51:45","slug":"feb-22-virtual-event-the-health-wonk-shop-prior-authorization-in-health-insurance-a-needed-tool-to-contain-costs-or-an-excessive-barrier-to-needed-care","status":"publish","type":"event","link":"https:\/\/www.kff.org\/event\/feb-22-virtual-event-the-health-wonk-shop-prior-authorization-in-health-insurance-a-needed-tool-to-contain-costs-or-an-excessive-barrier-to-needed-care\/","title":{"rendered":"Prior Authorization in Health Insurance: A Needed Tool to Contain Costs or an Excessive Barrier to Needed Care?"},"content":{"rendered":"\n<div\n\tclass=\"wp-block-kff-shared-content--standard-layout wp-block-kff-shared-content\">\n\t\n\n<section class=\"wp-block-kff-shared-content-main\">\n\t\t\t<div class=\"post-header\">\n\t\t\t\t\t\n\t<h1 class=\"post-header__title\">Prior Authorization in Health Insurance: A Needed Tool to Contain Costs or an Excessive Barrier to Needed Care?<\/h1>\n\n\t\n\t\t\t\n<div class=\"post-header__meta\">\n\t\t\t<div>\n\t\t\t<span class=\"post-header__meta-label\">Event Date:<\/span>\n\t\t\t<date>Feb 22, 2024<\/date>\n\t\t<\/div>\n\t\n\t\n\t\n\t\n\t<\/div>\n\t\n\t<div class=\"post-header__social-sharing\">\n\t\t<button class=\"post-header__social-sharing__button print\">\n\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t<path d=\"M4.348 2.5v3.391H2.783A.787.787 0 0 0 2 6.674v4.696c0 .429.353.782.783.782h1.565V14.5h7.304v-2.348h1.565c.43 0 .783-.353.783-.782V6.674a.787.787 0 0 0-.783-.783h-1.565V2.5H4.348Zm.522.522h6.26v2.87H4.87v-2.87ZM2.783 6.413h1.782a.26.26 0 0 0 .085 0h6.697a.26.26 0 0 0 .086 0h1.784c.148 0 .261.114.261.26v4.697c0 .147-.113.26-.26.26h-1.566V9.283H4.348v2.347H2.783a.257.257 0 0 1-.261-.26V6.674c0-.147.113-.261.26-.261Zm9.39.783a.522.522 0 1 0 0 1.043.522.522 0 0 0 0-1.043ZM4.87 9.804h6.26v2.043a.264.264 0 0 0 0 .086v2.045H4.87v-2.043a.261.261 0 0 0 0-.085V9.804Zm1.043.783a.262.262 0 0 0-.265.26.26.26 0 0 0 .265.262h4.174a.26.26 0 1 0 0-.522H5.913Zm0 1.043a.26.26 0 1 0 0 .522h3.13a.26.26 0 1 0 0-.522h-3.13Zm0 1.044a.26.26 0 1 0 0 .522h4.174a.262.262 0 0 0 .264-.261.26.26 0 0 0-.264-.261H5.913Z\" fill=\"#004B88\" stroke=\"#004B88\" stroke-width=\".5\"\/>\n\t\t\t<\/svg>\n\n\t\t\tPrint\t\t<\/button>\n\t\t<a href=\"mailto:?subject=Prior%20Authorization%20in%20Health%20Insurance%3A%20A%20Needed%20Tool%20to%20Contain%20Costs%20or%20an%20Excessive%20Barrier%20to%20Needed%20Care%3F&#038;body=https%3A%2F%2Fwww.kff.org%2Fevent%2Ffeb-22-virtual-event-the-health-wonk-shop-prior-authorization-in-health-insurance-a-needed-tool-to-contain-costs-or-an-excessive-barrier-to-needed-care%2F\" class=\"post-header__social-sharing__button\">\n\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t<path d=\"M2.333 4.25h-.25v9.14h12.5V4.25H2.333Zm1.083 1.693-.353-.2V5.23h10.54v.513l-.353.2L8.333 8.73 3.416 5.943Zm-.353 6.467V6.884l.107.06 5.04 2.857.123.07.123-.07 5.04-2.857.107-.06v5.526H3.063Z\" fill=\"#004B88\" stroke=\"#004B88\" stroke-width=\".5\"\/>\n\t\t\t<\/svg>\n\n\t\t\tEmail\t\t<\/a>\n\t\t<button class=\"post-header__social-sharing__button copy\">\n\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t<path d=\"M11.533 2.9c-.615 0-1.23.235-1.697.702L8.502 4.936a2.4 2.4 0 0 0-.575 2.46l.958-.958a1.32 1.32 0 0 1 .371-.748l1.334-1.333a1.331 1.331 0 0 1 1.886 0c.52.52.52 1.365 0 1.885l-1.334 1.333c-.21.21-.474.331-.748.372l-.958.958a2.393 2.393 0 0 0 2.46-.576l1.334-1.333a2.402 2.402 0 0 0 0-3.394 2.393 2.393 0 0 0-1.697-.702Zm-1.61 3.46a.533.533 0 0 0-.367.162l-3.2 3.2a.533.533 0 1 0 .754.754l3.2-3.2a.534.534 0 0 0-.387-.915ZM6.586 7.973a2.388 2.388 0 0 0-1.816.697l-1.334 1.333a2.403 2.403 0 0 0 0 3.394 2.393 2.393 0 0 0 1.697.702c.614 0 1.229-.234 1.697-.702l1.333-1.334a2.4 2.4 0 0 0 .576-2.46l-.959.958a1.32 1.32 0 0 1-.37.749l-1.334 1.333a1.334 1.334 0 0 1-1.886-1.885l1.334-1.334c.21-.21.474-.331.748-.372l.958-.957c-.21-.07-.426-.11-.644-.122Z\" fill=\"#004B88\"\/>\n\t\t\t<\/svg>\n\n\t\t\t<span>Copy Link<\/span>\n\t\t<\/button>\n\t\t\t<\/div>\n\t<\/div>\n\t\t\t\n<p class=\"wp-block-paragraph\">\u00a0<\/p>\n\n<iframe loading=\"lazy\" class=\"wp-block-html\" src=\"https:\/\/embed.acast.com\/6238b4c3dc63710013be6018\/65d7ab62cb2a2600168a8fcc?theme=light\" frameBorder=\"0\" width=\"100%\" height=\"80px\"><\/iframe>\n\n<p class=\"wp-block-paragraph\">\u00a0<\/p>\n\n<p class=\"wp-block-paragraph\">Nearly 1 in 5 consumers with health insurance say their insurer delayed or denied care in the past year due to its requirements for prior authorization, a process through which insurers can require patients to obtain approval in advance before they will agree to cover specific services.<\/p>\n\n<p class=\"wp-block-paragraph\">Insurers point to prior authorization as a tool to limit unnecessary and ineffective care, thereby reducing costs. However, the practice is also drawing increased scrutiny amid concerns that it creates unreasonable barriers to patients getting needed care and generates excessive paperwork burdens on doctors and other providers. Last month, federal regulators finalized new rules to govern how insurers use prior authorization in Medicare Advantage, Medicaid, the Children\u2019s Health Insurance Program, and the Affordable Care Act\u2019s federal Marketplace plans, while lawmakers are weighing potential broader legislation.<\/p>\n\n<p class=\"wp-block-paragraph\">On February 22, a panel of four experts joined Larry Levitt, KFF\u2019s executive vice president for health policy, for a 45-minute discussion addressing the future of prior authorization requirements in health care. The panel discussed why insurers use prior authorization, its impact on patients and providers, and how the new regulations may change current practices. They also examined the potential for further regulatory or legislative actions to address ongoing concerns.<\/p>\n\n<p class=\"wp-block-paragraph\"><strong>Moderator<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li class=\"wp-block-list-item\"><a href=\"https:\/\/www.kff.org\/person\/larry-levitt\/\"><strong>Larry Levitt<\/strong><\/a><strong>,<\/strong> Executive Vice President for Health Policy, KFF<\/li>\n<\/ul>\n\n<p class=\"wp-block-paragraph\"><strong>Panelists<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li class=\"wp-block-list-item\"><a href=\"https:\/\/www.linkedin.com\/in\/troyen-brennan-494bb533\/\"><strong>Troyen Brennan<\/strong><\/a><strong>, MD, <\/strong>Adjunct Professor of Health Policy and Management, Harvard T.H. Chan School of Public Health, and a former executive at CVS Caremark and Aetna<\/li>\n\n<li class=\"wp-block-list-item\"><a href=\"https:\/\/www.mskcc.org\/cancer-care\/doctors\/fumiko-chino\"><strong>Fumiko Chino<\/strong><\/a>, <strong>MD<\/strong>, Radiation Oncologist, Memorial Sloan Kettering Cancer Center<\/li>\n\n<li class=\"wp-block-list-item\"><a href=\"https:\/\/www.linkedin.com\/in\/annashoward\/\"><strong>Anna Schwamlein Howard<\/strong><\/a>, Principal, Policy Development, American Cancer Society Cancer Action Network<\/li>\n\n<li class=\"wp-block-list-item\"><a href=\"https:\/\/www.kff.org\/person\/kaye-pestaina\/\"><strong>Kaye Pestaina<\/strong><\/a>, Vice President and Director of the Program on Patient and Consumer Protection, KFF<\/li>\n<\/ul>\n\n<p class=\"wp-block-paragraph\">KFF\u2019s virtual <a href=\"https:\/\/connect.kff.org\/e3t\/Ctc\/RB+113\/c1ThL04\/VWdfmF3mb4XGW1LSXLQ3DFl2NW65wf3Z55VVJNN8_nRF29kX3qW50lwYY6lZ3ppVghW6S35Ks5-W9c5H1T7H9gyYW6fY3VD8v3HxTW5sHPlN3hYLTXW9fC2cK1yWwL6W6dspbT63CQtYW8wVPJz1tQhWsW8ggQ_r1VfpQdW1K4lCD1ZXSd2N2WFJb_fZry5TRtL88DHXZxW16BpRV6J01NFVHBWfC4RYj6rW2VHmgH5vDh0dW601bh31BRdHzW80WM6c81Q7qWW2WQJZB8QD1SsW2HVGlT19_P7_W1pKprY86l5X7W4vzXQC382-lDW5xX-f7251NhHW4rmFWk2BQNb8N3M9d3mGpQsqW2ZX71Z8ryPj4V5KBWJ8mq-gfW7GvByz4Tp32vV9_gtf2yPZ6CW2SJMYX2mRKSVW33Z-sb1kDH_tVYzjF98RMj5GW13YjJJ6DrPxYW69mdQW7_xjtqW424t3r1-mvNQW6nHr-K7wG7v_W6ZP6sk1QF6HTW2xc5JW8HVl3YW8FCtfn2fjVHwW5bXySn5w4qG6W6pjDZY32BBpSW7lg6rr1S3jgHW32W8rp5r_F1lVwhggR7MhH4_VGZhgk2rJzs_W2GXwgl5jVV_rW2YsFP28sTtzdW6DPX-r985FTpW6-w-Ys4zJq7GW2K5TSG98p2yZW6rmWVy4S4s87N7PVXt4nfDZ9W77vvW-13BVM0W95rTV93HHmHrW73W-mm12X53qW7kP-Nc7vVPMgW2nNWJn17V89zW8C5_2n1dgPTYW28Bg6H17s2-LW41hd2_191dBtW49s0pH162cGHW44pwcG4y9gpSN78V--SctMK6W7pKxfp341pLPW2CGYRp2DgwfHW92HNC37WV2KRf8Ct3R-04\">Health Wonk Shop<\/a> series features in-depth policy discussions with experts that go beyond the news headlines to provide greater insights.<\/p>\n\n<p class=\"wp-block-paragraph\">Subscribe and listen to the The Health Wonk Shop podcast through <a href=\"https:\/\/podcasts.apple.com\/us\/podcast\/the-health-wonk-shop-presented-by-kff\/id1618289638\">Apple Podcasts<\/a>, <a href=\"https:\/\/open.spotify.com\/show\/1jE4GuS2XqAuDzZiyQQDld\">Spotify<\/a>, or <span class=\"ui-provider a b c d e f g h i j k l m n o p q r s t u v w x y z ab ac ae af ag ah ai aj ak\">wherever you get your podcasts.<\/span><\/p>\n \n\t<div class=\"post-footer\">\n\t<div class=\"post-footer__title\">More On<\/div>\n\t<div class=\"post-footer__links\">\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/topic\/other-health\/\">\n\t\t\t\tOther Health\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/prior-authorization\/\">\n\t\t\t\tPrior Authorization\t\t\t<\/a>\n\t\t\t<\/div>\n<\/div>\n\t<\/section>\n\n<section class=\"wp-block-kff-shared-content-sidebar\">\n\t\t\t\t\t\t<div class=\"wp-block-kff-shared-slab--blue wp-block-kff-shared-slab\">\n\t\t\t\t<h2 class=\"wp-block-kff-shared-slab__heading\">\n\t\t\t\t\tEvent Materials\t\t\t\t<\/h2>\n\t\t\t\t<div class=\"wp-block-kff-share-slab__content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"wp-block-file\">\n\t\t\t\t\t\t\t<a id=\"43aaa293-6cb1-4d54-b9d6-68039196e3a2\" href=\"https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2024\/02\/Event-Transcript.pdf\">\n\t\t\t\t\t\t\t\tTranscript\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\n\t\t\n<div class=\"wp-block-kff-shared-related-content--green wp-block-kff-shared-related-content\">\n\t<h2 class=\"wp-block-kff-shared-related-content__heading\">Also of Interest<\/h2>\n\t<div>\n\t\t\t<div class=\"wp-block-kff-shared-related-content__card\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/affordable-care-act\/consumer-problems-with-prior-authorization-evidence-from-kff-survey\/\" class=\"wp-block-kff-shared-related-content__link\">\n\t\t\t\t<h3 class=\"wp-block-kff-shared-related-content__card-title\">\n\t\t\t\t\tConsumer Problems with Prior Authorization: Evidence from KFF Survey\t\t\t\t<\/h3>\n\t\t\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"wp-block-kff-shared-related-content__card\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/affordable-care-act\/kff-survey-of-consumer-experiences-with-health-insurance\/\" class=\"wp-block-kff-shared-related-content__link\">\n\t\t\t\t<h3 class=\"wp-block-kff-shared-related-content__card-title\">\n\t\t\t\t\tKFF Survey of Consumer Experiences with Health Insurance\t\t\t\t<\/h3>\n\t\t\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"wp-block-kff-shared-related-content__card\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/mental-health\/examining-prior-authorization-in-health-insurance\/\" class=\"wp-block-kff-shared-related-content__link\">\n\t\t\t\t<h3 class=\"wp-block-kff-shared-related-content__card-title\">\n\t\t\t\t\tExamining Prior Authorization in Health Insurance\t\t\t\t<\/h3>\n\t\t\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\t\t\t<\/section>\n\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Nearly 1 in 5 consumers with health insurance say their insurer delayed or denied care in the past year due to its requirements for prior authorization, a process through which insurers can require patients to obtain approval in advance before they will agree to cover specific services. On February 22, a panel of four experts joined Larry Levitt, KFF\u2019s executive vice president for health policy, for a 45-minute discussion addressing the future of prior authorization requirements in health care. The panel discussed why insurers use prior authorization, its impact on patients and providers, and how the new regulations may change current practices. They also examined the potential for further regulatory or legislative actions to address ongoing concerns.<\/p>\n","protected":false},"author":155412812,"featured_media":613536,"template":"","meta":{"exhibits":[],"authors":[],"jetpack_post_was_ever_published":false,"ep_exclude_from_search":false,"_classifai_error":"","_classifai_text_to_speech_error":"","show_featured_image":false,"search_keywords":"Event","shortlink":"","event_start_date":"2024-02-22","event_rsvp_instructions":"","event_end_date":"","event_time":{"hours":0,"minutes":0},"event_timezone":"","event_rsvp":"","event_rsvp_link":"","event_rsvp_contacts":"","event_address":"","event_video_embed_id":"","event_materials":[{"id":"43aaa293-6cb1-4d54-b9d6-68039196e3a2","title":"Transcript","fileId":613563,"fileUrl":"https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2024\/02\/Event-Transcript.pdf"}],"footnotes":""},"categories":[1035],"tags":[579145436],"series":[579145223],"program":[],"content-types":[579145491],"class_list":["post-611873","event","type-event","status-publish","has-post-thumbnail","hentry","category-other-health","tag-prior-authorization","series-health-wonk-shop","content-types-event"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.9 (Yoast SEO v25.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Prior Authorization in Health Insurance: A Needed Tool to Contain Costs or an Excessive Barrier to Needed Care? | KFF<\/title>\n<meta name=\"description\" content=\"Nearly 1 in 5 consumers with health insurance say their insurer delayed or denied care in the past year due to its requirements for prior authorization, a process through which insurers can require patients to obtain approval in advance before they will agree to cover specific services. On February 22, a panel of four experts joined Larry Levitt, KFF\u2019s executive vice president for health policy, for a 45-minute discussion addressing the future of prior authorization requirements in health care. The panel discussed why insurers use prior authorization, its impact on patients and providers, and how the new regulations may change current practices. 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