Advocacy & Practice Updates — Clinical Updates
ASRS Voices Support for AMA-Led Coalition to Reform Utilization Management Programs
The ASRS applauds the new American Medical Association-led coalition seeking reform of utilization management programs, and pledges its support in reducing the negative impact these activities, including prior authorization and step therapy, impose on patients and providers.
As a member of the AMA House of Delegates, the ASRS enthusiastically supported the report that called for the creation of the coalition and outlined the 21 underlying principles that will guide its work. These principles, which align with ASRS's prior advocacy efforts, maintain that prior authorization programs could be improved by applying the principles' common-sense concepts grouped in five broad categories:
- Clinical validity;
- Continuity of care;
- Transparency and fairness;
- Timely access and administrative efficiency; and,
- Alternatives and exemptions.
The coalition which is a multi-stakeholder group representing patients, physicians, hospitals and pharmacists, is calling for "health plans, benefit managers and any other party conducting utilization management, as well as accreditation organizations, to apply the principles to utilization management programs for both medical and pharmacy benefits. We believe adherence to these principles will ensure that patients have timely access to treatment and reduce administrative costs to the health care system."
(Published January 26, 2017)