| The new head of the Centers for Medicare and Medicaid Services, Mehmet Oz, expressed interest in his Senate hearing in dealing “with the intense frustration the American people have with pre-authorization” — the extra paperwork required before health insurers will authorize additional medical care. His agency is starting to do just that, as I reported April 29. CMS is looking at ways to cut the number of procedures that are subject to prior authorization, as well as automating some decisions so patients can get answers faster, according to people familiar with the discussions who weren’t authorized to speak publicly. The sheer time and red tape required to get prior authorization frustrates doctors and patients, and they are often infuriated when insurers deny medical treatments. The public’s loathing of health insurers exploded onto social media following the shooting of a UnitedHealth executive in December. One doctor posted at that time that many medical professionals thought it was related to denying access to care, which “shows how bad our system is.” There’s widespread public support for action. A KFF poll in January asking whether Congress and the White House should more closely regulate insurers on approval of services and prescription drugs, and 61% of Democrats, 59% of independent voters and 45% of Republicans said it should be a top priority. CMS’ initial discussions on prior authorizations are the first actions being considered by the Trump administration on the issue. Despite the lack of early details, patient advocates cheered the news. David Lipschutz, codirector at the Center for Medicare Advocacy, says coverage-denying has been “a common cost-saving” move for private health insurers. “While it has taken some time for that awareness to spread, and the negative affects to be publicized, it is good to finally see some action being taken,” he says. The Better Medicare Alliance, whose members include Medicare Advantage insurers, says “prior authorization helps keep health-care costs low and ensures seniors are getting the best care.” But the group does support “transitioning prior authorizations to electronic processes.” Prior authorization “should be easier for seniors and providers,” the group’s president and CEO Mary Beth Donahue says. I’ll be watching closely to see what happens. — Rachel Cohrs Zhang | 
