Physician Practice Roundup—Prior authorization delays impact outcomes; New York doctors indicted for accepting bribes

30% of doctors wait at least 3 days for prior authorization decisions

Physicians say they face long wait times for insurers to process prior authorizations and the delays can negatively impact patient outcomes. 

The American Medical Association surveyed (PDF) 1,000 physicians, and 64% said they wait at least one business day for insurers to decide on prior authorization. Nearly one-third (30%) said they wait at least three business days for decisions. 

The vast majority of physicians surveyed said that lag time can have serious consequences for patients; 92% said the prior authorization process can lead to delays in access to care, and 78% said that waiting for a decision from insurers "sometimes, often or always" causes patients to abandon certain treatments entirely. (Fierce Healthcare)

5 doctors indicted for accepting bribes from pharma company

Five Manhattan doctors were indicted for accepting bribes and kickbacks in the form of speaker fees from a pharmaceutical company in exchange for prescribing millions of dollars’ worth of a fentanyl-based spray, a highly addictive painkiller.

The doctors were arrested Friday and pleaded not guilty in federal court, according to news reports. Prosecutors say the doctors collected tens of thousands of dollars working for the Insys Therapeutics Inc.’s “speakers bureau” and received fees for sham educational programs over a four-year period. Two former pharmaceutical company employees have pleaded guilty and are cooperating with the government. (U.S. Attorney’s Office)

Biden pushes for specifics on federal data-sharing initiatives

Reactions to the Trump administration’s plan to provide patients access to their medical data are still pouring in with different views about how the government should manage that transition.

In an op-ed for Fortune, former Vice President Joe Biden, now the co-chair of the Biden Cancer Initiative, said he supported efforts by the current administration to increase interoperability, but wants to see “real action” behind those efforts to ensure patients aren’t “made to jump through hoops to access and share their own data.” (Fierce Healthcare)

MedPAC submits report to Congress recommending end to MIPS

The Medicare Payment Advisory Commission submitted its March 2018 report to Congress, which includes a recommendation to replace the Merit-based Incentive Payment System (MIPS).

MedPAC members voted in January that MIPS, a Medicare payment system for physicians and other clinicians that was implemented last year, be eliminated and outlined a path for a new voluntary value program to replace it. MedPAC outlined the reasons for its recommendation in a 15-page chapter in the report (PDF). (MedPAC)

Puerto Rico’s healthcare system 6 months after Hurricane Maria

Although Hurricane Maria ripped through Puerto Rico six months ago, 1 in 10 permanent health centers on the island still lack consistent electricity.

The good news for Puerto Rico’s healthcare network is that all the island’s health centers have reopened following the devastating category 4 hurricane that hit on Sept. 20, 2017, reports the Henry J. Kaiser Family Foundation. By contrast, a week after the storm only 11 of Puerto Rico’s 69 hospitals had power or fuel. The conditions were bad enough to force the U.S. Department of Health and Human Services to evacuate more than 150 dialysis patients and 130 critical care patients from Puerto Rico and the U.S. Virgin Islands to the U.S. mainland. (Fierce Healthcare)

Trump plans to build a 'nationally interoperable' PDMP

Part of a plan unveiled by President Donald Trump on Monday to address opioid abuse includes transitioning states to a nationally interoperable Prescription Drug Monitoring Program (PDMP) designed to reduce the number of opioid prescriptions across the country.

Trump’s plan, which aims to reduce the number of opioid prescriptions by one-third over the next three years, is part of a three-pronged effort to stem the opioid epidemic through increased awareness, tighter prescribing practices and a push to prosecute drug dealers with the death penalty.

A nationally interoperable PDMP network that shares prescribing data across state lines is popular among health IT and drug abuse experts that see it as one of several tools to improve data collection and integrate clinical decision support tools. (Fierce Healthcare)