The Georgia Psychiatric Physicians Association is a district branch of The American Psychiatric Association.  We are the only statewide organization representing Georgia psychiatrists and their patients. Our members are dedicated to promoting professional values and ethics in the practice of psychiatry; improving patient access to quality mental health care; lifelong learning and professional development; and supporting education and advocacy for our profession, our patients and their families.

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MAG & GPPA ENCOURAGING LAWMAKERS TO TAKE MORE ACTION ON PRIOR AUTHORIZATION

ATLANTA – The Medical Association of Georgia (MAG) and the Georgia Psychiatric Physicians Association (GPPA) are encouraging state lawmakers to take additional action to address the prior authorization process in 2022 – keeping in mind that insurers regularly use prior authorization as a tactic to delay patient care and/or determine which treatments or prescriptions they will cover to reduce their costs.   

“Physicians in the state applaud Senator Kay Kirkpatrick for the vision and leadership she demonstrated when she introduced a prior authorization bill (S.B. 80) in 2021,” says MAG President Lisa Perry-Gilkes, M.D., F.A.C.S. “Passing that bill was a great first step, but physicians are calling for lawmakers to build on that foundation with additional legislation that will ensure that Georgians get the treatment and medicine that they need and that their physicians have prescribed.”  

S.B. 80 1) requires insurers to post information on their prior authorization process/requirements on their website before changes go into effect and 2) requires statistical reporting on approvals and denials and 3) gives physicians a chance to speak to a physician or other qualified health care provider who is employed by the insurer during the appeals process and 4) established deadlines for insurers to respond to prior authorization requests and 5) prevents insurers from revoking, denying or changing a prior authorization approval for 45 days unless the prior authorization is for a Schedule II controlled substance.  

During the 2022 legislative session, MAG and GPPA would like to see lawmakers pass legislation that addresses prior authorizations for chronic conditions and electronic prior authorization (ePA) systems and that will further reduce the heavy administrative burden that’s associated with the prior authorization process.  

GPPA President Brian Miller, M.D., explains that, “Physicians prescribe specific drugs to specific patients because it’s what they believe will result in the best outcome. Insurers should not be able to use some arbitrary formula to override a physician’s judgment or dictate a patient’s care.” 

Dr. Miller also points out that, “The vast majority of the individuals who work for these insurance companies who oversee the prior authorization process simply do not have enough education or training to understand the ramifications of their decisions. And unlike physicians and other health care professionals, they also know that they are not going to be held liable for any negative outcomes.”   

And Dr. Perry-Gilkes stresses that, “The alternative drugs that these insurers propose to reduce their costs are often less effective and/or come with some unnecessary and unacceptable side effects.”