- Title Information
- Title
- Understanding Prior Authorization: Current Landscape, Practices, and Challenges
- Type of Resource (primo)
- technical_reports
- Abstract
- Prior authorization is a process used by private health insurance plans to determine whether a specific medical service, procedure, or medication will be covered before a patient receives it. This mechanism may be applied to more complex, higher-cost, or higher-risk interventions, particularly when less expensive or less intensive alternatives may be available. The purpose of prior authorization is to ensure that care is medically necessary, evidence-based, and cost-effective. Growing concerns about prior authorization have garnered the attention of policymakers in recent years. Critics note that prior authorization can delay or deny needed care, increase administrative costs, and drive clinician burnout. This issue brief provides an overview of the use of prior authorization and its impact on the health care system. We then provide an overview of recent federal and state policy actions related to prior authorization.
- Name
- Name Part
- Corrie Mook
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name
- Name Part
- Jeffrey Marr
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name
- Name Part
- Hayden Rooke-Ley
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name
- Name Part
- Jared Perkins
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name
- Name Part
- Lindsey Murtagh
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name
- Name Part
- Nathan Hostert
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Name
- Name Part
- Ayesha Rahim
- Role
- Role Term (marcrelator)
(authorityURI="http://id.loc.gov/vocabulary/relators", valueURI="http://id.loc.gov/vocabulary/relators/aut")
- Author
- Origin Information
- Date Created
- 2026
- Subject (Local)
- Topic
- Prior Authorization
- Genre
- Policy Brief
- Access Condition:
use and reproduction
- All rights reserved
- Access Condition:
rights statement
(href="http://rightsstatements.org/vocab/InC/1.0/")
- In Copyright
- Access Condition:
restriction on access
- All Rights Reserved
- Identifier:
DOI
- 10.26300/psqz-1b42