Kentucky Journalist Shares Firsthand Struggles She’s Encountered with Prior Authorization 

By Consumers for Quality Care, on February 14, 2024

The Courier Journal’s Bonnie Jean Feldkamp, who suffers from an autoimmune disease, knows all too well about the prior authorization process, which can often hurt health outcomes by making it harder for patients to access crucial treatments.  

Although prior authorization is meant to be a cost-control measure, patient advocates suspect that some insurers are exploiting it to deny patients care.  

A 2022 American Medical Association survey found that prior authorization delays medically necessary treatment nearly every time, and that it resulted in hospitalization in a quarter of all cases.  

Feldkamp’s prior authorization story began when her husband got a new job, and in turn, a new insurance plan. A medication she had been taking for 14 years to treat her psoriatic arthritis now required prior authorization. Unfortunately, her new insurer denied coverage, leading to appeals and delay of care, hurting her health and personal well-being.  

Although her preferred medication was eventually approved, Feldkamp’s experience highlights the widespread issues faced by patients nationwide. 

Recently, the Centers for Medicare & Medicaid Services (CMS) finalized a new rule that will reduce the decision times typically associated with prior authorization.  

CQC applauds actions to reform the prior authorization process and urges both lawmakers and providers to eliminate needless, burdensome processes that prevent consumers from receiving the medical care they need.