Gatekeepers of Care

• The 'Psychological Warfare' of Prior Authorization The burdens of prior authorization requirements are leaving lasting marks on physicians. An oncologist still recalls one prior authorization fight that meant life and death for a patient.
  Medscape Medical News, July 06, 2023
• Prior Auth Has Radiation Onc Deferring to Business Manager One radiation oncologist reflects on an odd, stressful element of prior authorization: the need to ask his business manager what he's allowed to do.
  Medscape Medical News, May 17, 2023
• 'Infuriating' Denial: Medicare Advantage Plan Reopens Case An oncologist was surprised to see that health insurer WellCare denied approval for a drug she had prescribed within the indication. Before she could appeal, WellCare restarted the review process.
  Medscape Medical News, April 19, 2023
• Divorce or Wait? 'Underinsurance' Forces Grave Decisions Misty Selph found herself with a rare metastatic cancer and an insurance plan that covered virtually none of the specialized care she required, forcing tough choices and delaying her care.
  Medscape Medical News, March 20, 2023
• 'Infuriating' Rx Denial Leaves Patient Without Antiemetics A Friday night insurance denial for a generic antinausea medication left an oncologist scrambling and a patient in unnecessary pain over the weekend.
  Medscape Medical News, February 16, 2023
• Oncologist to Insurer: 'This Denial Will Not Stand.' Oncologist Rebecca Shatsky, MD, yelled at an insurance company physician during a peer-to-peer when he refused to approve a drug for her patient. Her office gave her a standing ovation.
  Medscape Medical News, January 17, 2023
• Have a Prior Auth Problem? Introducing 'Gatekeepers of Care' This new column will explore the ways in which insurance companies may dictate or restrict cancer care. Each month, oncologists and patients will share their experiences. But first, how did we get here?
  Medscape Medical News, January 17, 2023