1. United States
2. N.J.
3. Letter

Reform prior authorization system prioritizing patient care over profits! The prior authorization process in healthcare is deeply flawed, causing significant harm to patients while enriching insurance companies. It is an unsustainable system jeopardizing the future of accessible and affordable healthcare in our country. Around 66% of prescriptions rejected at the pharmacy require prior authorization [1], with only 29% of patients ultimately receiving the originally prescribed medication and 40% abandoning treatment altogether [2]. The administrative burden is staggering, with physicians spending on average 20 hours per week navigating this bureaucracy, totaling $23 to $31 billion annually across the healthcare system [3], enriching insurance companies at the expense of patient care and outcomes. Delays caused by prior authorizations directly impede patients from receiving timely treatment, with 78% of physicians reporting that prior authorizations result in patients forgoing necessary care [4], harming access and clinical quality for up to 92% of doctors [5]. While intended to control costs, prior authorizations frequently lead to worsened conditions and higher overall medical expenses for denied patients [6]. Constituents feel growing frustration and powerlessness to fix this fundamentally broken system which prioritizes corporate profits over patient well-being. We are equally frustrated with inaction on the part of our elected representatives regarding this problem. Comprehensive reform is desperately needed to alleviate excessive administrative burdens draining resources from patient care, prevent treatment delays jeopardizing health outcomes, and realign healthcare priorities with people rather than profits. We deserve better and NJ has a responsibility to lead the rest of the nation by taking state action to protect the future of healthcare for its citizens. This needs to be a priority and constituents are watching to see who will step up and take action. [1] https://www.ama-assn.org/system/files/2021-07/prior-authorization-reform-progress-update.pdf [2] https://www.ama-assn.org/system/files/2019-02/prior-auth-survey.pdf [3] https://www.ama-assn.org/practice-management/sustainability/prior-authorization-burdens-have-increased-huge-costs [4] https://www.ama-assn.org/system/files/2021-04/prior-authorization-survey.pdf [5] https://www.ama-assn.org/system/files/2021-04/prior-authorization-survey.pdf [6] https://www.ama-assn.org/practice-management/prior-authorization-reform- resources/effects-of-prior-authorization