ASTRO: Prior Authorization Obstacles Delaying Treatment

Almost all radiation oncologists report their patients are delayed from receiving life-saving treatment

THURSDAY, May 2, 2019 (HealthDay News) -- Prior authorization obstacles are delaying patient access to radiation oncology treatments, according to a survey released by the American Society for Radiation Oncology.

A total of 620 radiation oncologists completed the survey online, and 53 responses were collected at the ASTRO Annual Meeting in October 2018. The findings, which examined the extent of the burden of prior authorization on patients treated, reflect a combined total of 673 responses.

According to the survey, 93 percent of radiation oncologists reported that their patients are delayed from life-saving treatments, with 31 percent reporting that the average delay lasts longer than five days. Overall, 73 percent of radiation oncologists reported that their patients regularly expressed concerns about delays caused by prior authorization; 32 percent of radiation oncologists were forced to use a different therapy for more than 10 percent of their patients due to these delays. Although most requests submitted by radiation oncologists are initially approved, 62 percent of respondents reported that most denials they receive from prior authorization review are overturned on appeal. Forty-four percent of respondents reported that their peer-to-peer reviews are generally not performed by a licensed radiation oncologist. Eighty-five percent of radiation oncologists were required to generate multiple treatment plans by radiation oncology benefit management companies.

"While the system may have been designed as a path to streamline and strengthen health care, it is in fact frequently harmful to patients receiving radiation therapy," Paul Harari, M.D., chair of the ASTRO Board of Directors, said in a statement. "In its current form, prior authorization causes immense anxiety and wastes precious time for cancer patients."

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