L A N C A S T E R M E D I C A L S O C I E T Y.O R G Patient Advocacy INSURANCE PRIOR AUTH DELAYS HARM PATIENTS Doctors Must Be Part of the Solution JEFF WIRICK, Pennsylvania Medical Society I nsurance companies say they use prior authorization to prevent physicians from prescribing too much medication or ordering too many tests. But physicians say the use of prior auth has grown out of control-and few stories illustrate it better than that of Joe Stanziano. Stanziano, who currently resides in Montgomery County (PA), owned a bakery in New Jersey. Ten years of carrying heavy bags of flour and working 18-hour days took a toll on his back. Stanziano had just undergone his fourth back surgery in five years and was taking pain medication to help with his recovery. Things were progressing well enough for Stanziano to begin taking a smaller dose of the pain medication-a process known as "tapering" that could eventually allow him to wean off the medication altogether. When his current allotment of pain medicine ran out, the withdrawal symptoms began. The problem is, Stanziano's insurance company denied payment of the lower dosage that his neurologist prescribed. Hours turned into days and Stanziano continued to wait for his insurance company's approval. Stanziano's neurologist prescribed a lower dose of pain medication five times. It was denied five times for up to a week before it was approved. LANCASTER 22 PHYSICIAN "Cold sweats. Shaking. You don't have control," Stanziano described. This wasn't a one-time mistake by his insurance company.