Prior authorization before getting treatments, medications, or surgeries isn’t uncommon for a lot of insurance companies. It’s used to help avoid unnecessary treatments, doubled treatment, and other problems that could happen.
This wouldn’t necessarily be a problem, however, the wait time for preapprovals has skyrocketed and it could potentially be a threat to a patient’s health.
According to cancer patient Ron Winters, the wait for pre-approval was weeks or months long and it was for basically everything he needed to get done.
“For them to take weeks — up to months — to provide an authorization is ridiculous,” Winters said. “It doesn’t matter if it’s cancer or not.”
He said that after his diagnosis it took four weeks for them to get approval from the VA just to remove the cancer. Once he finished chemo, he had to wait another month for the VA to approve the removal of his bladder. He stated that even with routine things he needed done he had to get pre-approval from the VA, which took time.
The VA acknowledged that this kind of care is not okay and stated that a “delay in care is never acceptable.” “We will also urgently review this matter and take steps to ensure that it does not happen again,” Terrence Hayes, the VA press secretary told KFF Health News.
It’s already an issue that cancer treatment is so expensive and overall a stressful process, that waiting weeks for approval is just another problem on top of it for cancer patients. It’s not something that cancer patients want to go through when they are fighting for their lives and going through one of the worst times they could be going through.
Winters is not the only cancer patient who’s struggling with delays and long approval times from the VA. Although many suggest that these pre-approvals do more good than harm, if we continue at this rate there will be more problems with patients facing delays.
“This is cruel and unusual,” said Chino, a radiation oncologist. A two-week delay could be deadly, and that it continues to happen is “unconscionable,” she said.
Many individuals with cancer aired their concerns when it came to getting proper healthcare in a reasonable timeframe, as well as navigating a system that seems so difficult to use.
“You have to navigate the most complicated system on the planet,” Chino said. “If you’re just sitting there waiting for them to take care of you, they won’t.”
