Prior authorization in children's health care and prescription delays due to insurance issues

Why do prior authorizations take so long? Is prior authorization required for emergency services? Why would insurance deny a medication?

Melissa Garretson, MD, a pediatric emergency physician at Cook Children’s Health Care System and a member of the AMA Board of Trustees, discusses how to talk to patients about prior authorization, why prior auth takes so long, and how the AMA is fighting to fix prior authorization. American Medical Association CXO Todd Unger hosts.

🩺 The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most — patients. We will meet this challenge together. Join us: https://ama-assn.co/JoinRenew

🗣 Get involved! Patients and physicians can share prior authorization stories at: https://ama-assn.co/FixPriorAuth

📋 AMA prior authorization survey: https://ama-assn.co/PriorAuth_stats_PDF

🗺️ 📍 Googling "prior authorization laws by state"? Use AMA prior authorization state law chart: https://ama-assn.co/PriorAuth_laws_PDF

📢 AMA prior authorization physician advocacy examples: https://ama-assn.co/PriorAuth_trainin...

📜 AMA prior authorization model bill: https://ama-assn.co/PriorAuth_legisla...

📊 Access AMA prior authorization legislation resources and research: https://ama-assn.co/PriorAuth_report

📚 AMA prior authorization reform and model legislation: https://ama-assn.co/PriorAuth_reform

🏛️ Stay up to date on AMA efforts to fix prior authorization policy: https://ama-assn.co/PriorAuth_policy

🥼 Go to https://ama-assn.co/FightingForDocs to learn more about our AMA advocacy priorities, including:
▹ Reforming Medicare payment
▹ Fighting scope creep
▹ Fixing prior authorization
▹ Reducing physician burnout
▹ Making technology work for physicians

00:00 AMA Update September 20, 2024
00:50 Prior authorization in emergency medicine
01:52 Emergency pediatric medicine: Why would prior authorization be denied?
02:26 Pediatric drug formulations for children (prior authorization in pediatric care)
03:00 Prior authorization emergency room example: UTI in children (pediatric urinary tract infection, E coli UTI treatment)
04:32 Pediatric prior authorization: Emergency seizure medication for child
05:33 ADHD medication for kids: Prior authorization for pediatric medication (ADHD medication shortage)
07:02 Pediatric seizure medication: Why are prior authorizations so difficult?
08:09 Physician burnout and prior authorization process
09:33 Fighting prior authorization and benefits of gold carding
10:40 Explaining prior authorization to patients

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