Physician Practice Roundup—AMA says health insurers guilty of ‘foot-dragging’ on prior authorization reform

Doctor on phone/fax
Most health insurers have not followed through on prior authorization reforms, an AMA survey found. (Getty/IPGGutenbergUKLtd)

AMA says health insurers guilty of ‘foot-dragging’ on prior authorization reform

A survey (PDF) of 1,000 physicians found that most health plans are not making meaningful progress on reforming the cumbersome prior authorization process, according to the American Medical Association.

After a year of “foot-dragging and opposition,” health insurers must make improvements to the process, the AMA said, as its survey indicates many of the reforms agreed to in a consensus statement signed in January 2018 have not been widely implemented by health plans.

The survey of doctors in December 2018 found just 8% said they work with a health plan that allows some providers to be exempt from prior authorization requirements. Physicians said phone and fax are still the most common methods for prior authorization, with only 20% saying their electronic health records system offers electronic prior authorization for prescription medications. (AMA survey—PDF)


2019 Drug Pricing and Reimbursement Stakeholder Summit

Given federal and state pricing requirements arising, press releases from industry leading pharma companies, and the new Drug Transparency Act, it is important to stay ahead of news headlines and anticipated requirements in order to hit company profit targets, maintain value to patients and promote strong, multi-beneficial relationships with manufacturers, providers, payers, and all other stakeholders within the pricing landscape. This conference will provide a platform to encourage a dialogue among such stakeholders in the pricing and reimbursement space so that they can receive a current state of the union regarding regulatory changes while providing actionable insights in anticipation of the future.

FDA acts to keep e-cigarettes out of kids’ hands

The U.S. Food and Drug Administration (FDA) released a draft guidance on Wednesday aimed at preventing e-cigarettes from getting into the hands of young people.

The draft guidance (PDF) is open for comment for 30 days before the agency moves to finalize the new policy. As a result, FDA Commissioner Scott Gottlieb, M.D., said in a statement that the agency expects that some flavored e-cigarette products will no longer be sold at all, others will continue to be sold but only in a manner that prevents youth access and some flavored cigars will no longer be sold. (FDA draft guidance (PDF), announcement)

Florida gender reassignment surgeon fired after posting graphic photos of patients’ genitals on Instagram

A University of Miami Health System doctor has been fired after sharing graphic photos on his personal Instagram account of patients, including pictures of genitalia.

Christopher John Salgado, M.D., section chief of the health system’s LGBTQ Center for Wellness, Gender and Sexual Health, posted photos including pictures of genitalia of some patients who were having gender reassignment surgery, according to the Miami Herald. A petition circulated online by transgender advocates called for the Florida Medical Board to take action.

A health system spokesman said Salgado was no longer employed there. The Herald said the doctor posted photos as recently as Valentine’s Day, when he shared a photo of the removed penis of a transgender patient and shaped it into a heart, with the comment, “There are many ways to show your love.” (Miami Herald report)

FDA approves a new generic valsartan after recalls create drug shortage

The Food and Drug Administration this week approved a new generic valsartan, a drug used to treat high blood pressure and heart failure.

The FDA prioritized the review of the drug to help relieve the recent shortage of this critical medicine as a result of multiple recalls of generic valsartan products from several manufacturers due to the finding of impurities. Approval was granted to Alkem Laboratories Limited. (FDA announcement)

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