Last year, many of America’s largest health insurers vowed to reduce their use of prior authorization — the extra layer of approval insurers require before covering a medical expense. The industry’s pledge came after massive backlash to the process from patients, providers and politicians. ProPublica’s reporting has found it can delay or outright deny patients’ critical medical care.
Data as of last year shows the industry is still relying heavily on the approval process. Now, ProPublica is looking into the ways that insurers’ continued use of prior authorization is impacting patients. We need your help to figure out if prior authorization is still leading to delayed or missed treatments, tests, medical equipment or medication.
If you are covered by a plan through Medicaid, Medicare, Children’s Health Insurance Program, or the Affordable Care Act marketplace — and have had a prior authorization request delayed or denied — we want to hear from you. Your experiences help us better understand the real-life stakes of prior authorization. (For this investigation, we’re not seeking responses from people with insurance through their employer at this time.)
We’re also interested in hearing from people whose jobs provide insight into the inner workings of prior authorization, including medical providers and their staff, along with insurance company employees and regulators.
Our team may not be able to respond to everyone personally, but we will read everything you submit. We appreciate you sharing your story, and we take your privacy seriously. We are gathering these stories for the purposes of our reporting and will contact you if we wish to publish any part of your story. We will not publish anything you send us without asking for additional consent.
