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MMA Gathering Input on Prior Authorization for Meds

[MMA News Now, Feb. 6, 2014] In its efforts to address the increasing administrative burden faced by Minnesota physicians, the MMA is seeking input from physicians and their clinic staff regarding the issue of attaining prior authorizations for medications.

“Minnesota physicians are often overwhelmed with the burden and complexity of documentation and other administrative tasks,” said Janet Silversmith, MMA’s director of policy. “The MMA is identifying ways to alleviate administrative burdens, starting with an effort to reduce the complexity associated with the prior authorization process for prescription medications.”

To help in this effort, the MMA has created a new webpage to gather input, which (unless noted otherwise) will be kept confidential.

“We’re going to gather input from our members for the next several months and use the findings to help inform where the greatest opportunities for improvement in the process exist,” Silversmith said.

Along with specifics regarding meds, insurance and medical specialty, the website will gather anecdotal information and ask for suggestions on how to improve the medication prior authorization process.

Number of views (839)/Comments (4)

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4 comments on article "MMA Gathering Input on Prior Authorization for Meds"

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david rhude, MD

2/11/2014 11:16 AM

Every DMARD (disease modifying antirheumatic drug) i order is questioned & bullied by the insurance companies. as a rheumatologist.... that is what i do for my patients. i treat complex chronic autoimmune disease with FDA approaved medications that in insurance industry prevents me from using . this has to stop! good luck.


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K. Wolter, Medical Assistant

2/14/2014 1:17 PM

The PA process is near impossible. We were given the Cover My Meds website to help alleviate the need to call the insurance but after attempting that online process and getting no response and calling the insurance (when we finally get someone on the line after being on hold for 30-90 minutes) we are told they have no idea what Cover My Meds is and we have to do it over the phone. As a MA we do NOT have the time to sit on hold this long. This process should be put back onto the patients some. They know what has worked and what hasn't better than anyone. The patient can ask what would be covered and then could avoid the PA all together. PLEASE FIX THIS PROCESS!


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M.Boorsma

2/17/2014 11:18 AM

When a pharmacy is denied coverage by insurance, either a prior authorization needs to be completed or the medication needs to be changed. It would be EXTREMELY helpful if the preferred list of the COVERED medications were printed for the doctor to review before they decide to have prior authorization work done.


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Lori N RT(R)

2/24/2014 11:06 AM

I use the MA form at this link: http://www.pfizerformularypro.com/restriction_documents/222_Minnesota%20State%20Medicaid%20Generic%20PA%20Form.pdf.

The coverage criteria and preferred alternatives to a medication thats not covered would speed up this whole process.

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