Knowledge Center

ATA survey reveals membership dissatisfaction with prior authorization transactions.

In a recent report to the U.S. Senate Committee on Finance, the Government Accountability Office (GAO) was asked to examine the Centers for Medicare & Medicaid Services’ (CMS’s) prior authorization programs, including its benefits and challenges. The GAO spoke with many providers, suppliers, and beneficiary group officials who reported on the benefits of prior authorization. However, these same groups also reported challenges, including difficulty obtaining the necessary documentation from referring physicians to submit a prior authorization (PA) request, even though CMS had created templates and other tools to address this concern.

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