Patient Impact on Prior Auth Delays

As the stories below show, prior authorization delays from insurance companies are hurting patients who need care. You can help reform prior auth in Pennsylvania by supporting House Bill 1293:

Insurance Prior Auth Delays Eastern PA Man From Weaning Off Opioids

Insurance companies say they use prior authorization to prevent physicians from prescribing too much medication or ordering too many tests. But physicians say the use of prior auth has grown out of control – and few stories illustrate it better than that of Joe Stanziano. Stanziano, who currently resides in Montgomery County (Pa.), used to own a bakery in New Jersey. Ten years of carrying heavy bags of flour and working 18-hour days took a toll on his back. Stanziano had just undergone his fourth back surgery in five years and was taking pain medication to help with his recovery. Click here to read full story 

Prior Auth Delays Allowed Pittsburgh Woman’s Undiagnosed MS to Progress

Kristen O’Toole lived a healthy, active life as communications consultant in Pittsburgh. That changed suddenly and dramatically in 2014 when she experienced back pain. As the pain intensified, O’Toole realized that something was seriously wrong. Her physician wanted to do an MRI to figure out the problem – which he suspected was a herniated disk – but told O’Toole that she would need to complete several sessions of physical therapy and get an x-ray before the insurance company would authorize the MRI. Click here to read full story 

‘What If I Would Have Died With This?’

Studies show that people suffering from severe, untreated sleep apnea die at rates more than three times of those without apnea. Pittsburgh resident Jeff Duncan was convinced he had a sleep disorder when his mother noticed he momentarily stopped breathing while taking a nap in late 2016. “I knew I had to do something about it,” he said. But delays from insurance prior authorizations kept him from receiving treatment for almost eight months. Click here to read full story