Neurosurgery Featured in Prior Authorization Article

On April 8, the AANS and the CNS issued a press release objecting to Medicare’s new prior authorization requirements for cervical fusion and spinal neurostimulators. In the release, AANS/CNS Washington Committee chair, John K. Ratliff, MD, FAANS, noted that neurosurgeons “care for patients who suffer from painful and life-threatening neurologic conditions, and prior authorization is causing unacceptable delays and denials of medical treatments, particularly for debilitating spine disorders.” He added, that “patients cannot afford to wait or jump through unnecessary hoops to get the care they need, so it is imperative that CMS reevaluate the use of prior authorization in Medicare.”

Subsequently, MedPage Today published an article titled “Doc Groups Object to New Prior Authorization Rules in Medicare.” The piece featured Katie O. Orrico, Esq., director of the AANS/CNS Washington Office. In her comments, Ms. Orrico noted that “without a clear rationale, increased volume is not in itself a justifiable reason for imposing prior authorization — particularly given the severe consequences to patients for delays in care.” She pointed out that “any increase in utilization is likely a result from appropriate changes in clinical practice, such as providing non-opioid pain treatment for spinal disabilities.” Finally, Ms. Orrico went on to state that “given the ‘Patients Over Paperwork’ initiative launched by the previous administration, we are dumbfounded why the agency chose to expand prior authorization in the face of overwhelming evidence ... that the expanded use of this utilization tool is causing significant administrative burden and delays in medically necessary care — to the detriment of patients ... In the context of the current policy related to these spine procedures — these delays could result in patients developing worsening neurological deficits, increased narcotic use, and avoidable patient suffering.”