Prior authorization is when your health insurance company has to approve a medicine, test, treatment, or procedure before your doctor can give it to you or prescribe it. 

Why is prior authorization reform necessary?

• One in three physicians report that prior authorization policies caused serious consequences for patients.
• Delayed or denied care can result in significant harm to health, including avoidable hospitalization, disability and permanent bodily harm, or even death.
• Caregivers have a significantly better understanding of the patient's condition and care plan and are best positioned to determine legitimate medical necessity.

"My daughter has an immune system disorder that requires a specific medication and has been on the medication for close to 10 years. It’s the only thing that assists her in getting better and keeps this particular situation in check. However, recently she left the children’s hospital to go to another hospital and the insurance refuses to cover her medication. But I want my daughter to have what works. If a doctor prescribes medication, he knows what’s best for his patient."
~ Walterine E., Kansas City

“My husband was diagnosed with multiple myeloma in 2022 at age 52. He had a bone marrow transplant in 2023 and is currently in remission. Per his physicians, he should have yearly PET scans to check his remission 
status. April 4, 2025, is his two-year mark for his PET scan. We are still battling with the insurance company to get his PET scan authorized.”
~ Julie G