New Bill Proposed to Reform Healthcare Prior Authorization
擬議新法案旨在改革醫療保健事先授權程序
更新於: 2026年6月12日 上午07:30
Prior authorization (PA) has long been a standard method for health insurers to manage costs and ensure patients receive appropriate treatments.
事前授權（Prior authorization, PA）長期以來一直是健康保險業者管理成本並確保患者獲得適當治療的標準方式。
Originally designed to ensure clinical necessity, PA is now widely viewed as an administrative burden that delays care and contributes significantly to physician burnout.
原本旨在確保臨床必要性的PA，現在廣泛被視為加重行政負擔的行為，這不僅延誤照護，更顯著加劇了醫生的倦怠感。
Recent data reveals that 94% of doctors report that these hurdles directly delay patient access to medical services, sometimes leading to adverse health outcomes.
最新數據顯示，94%的醫生表示，這些障礙直接延誤了患者獲取醫療服務的機會，有時甚至導致不良的健康結果。
To combat this, bipartisan federal efforts like the Improving Seniors' Timely Access to Care Act aim to modernize the system through electronic standardization and real-time decision-making.
為了解決這一問題，聯邦層級的兩黨努力如《改善長者即時獲取照護法案》（Improving Seniors' Timely Access to Care Act），旨在透過電子化標準與即時決策來使系統現代化。
These initiatives seek to mandate transparency, requiring insurers to report their approval and denial rates while ensuring clinical oversight by qualified experts.
這些倡議尋求強制透明化，要求保險公司報告其核准與拒絕的比率，並確保由合格專家進行臨床監督。
Beyond federal legislation, individual states are taking matters into their own hands by implementing 'gold-carding' programs, which exempt high-performing providers from certain requirements, and enforcing stricter response deadlines.
除了聯邦立法外，各州也自行採取行動，實施「黃金卡」（gold-carding）計畫，免除績效卓越的醫療提供者的部分要求，並執行更嚴格的回應期限。
While industry experts acknowledge the complexity of healthcare reform, there is growing consensus among providers and patient advocates that the status quo is unsustainable.
雖然業界專家承認醫療改革的複雜性，但醫療提供者與病友倡導團體間日益達成共識，即現狀已無法維持。
Modernizing prior authorization is now a critical step toward prioritizing patient welfare over administrative bureaucracy.
現代化事前授權現在是優先考量患者福祉勝過行政官僚主義的關鍵一步。
