Simplify Prior Authorization

After the release of a comprehensive report on Private Payer Prior Authorization in Canada in Fall 2020, the Simplify Prior Authorization (SPA) initiative was created to advocate for improvements in the prior authorization (PA) claims process. Since then, SPA has shared new insights into PA and explored the many opportunities for improvement through multiple media.

The SPA initiative has also been instrumental in fostering a made-in-Canada electronic prior authorization (ePA) solution, and will continue to support opportunities to drive improvements in PA. Look for our announcement and webinar coming soon on a new tool that will help stakeholders evaluate PA processes.

A businesswoman enjoying an efficient healthcare process on a digital tablet.

Why this Website

This website is a resource for all stakeholders involved in the prior authorization (PA) process. Everyone should find some useful information about the process, tips on navigating prior authorization, and answers frequently asked questions. You can also learn about electronic prior authorization (ePA) and why it will be an easier and more efficient claims process for patients and everyone in the circle of care, including physicians, payers and pharmacy.

I am a...

Cancer patient sitting with her daughter.
Patient or
Patient Group
Group of doctors looking at the camera.
Physician, Prescriber or Pharmacist
Businesswoman shaking hands with colleague.
Plan Sponsor or Advisor
Group of individuals sitting in a circle on chairs having a discussion.
Patient Support
Program
A businessman using a computer while on a phone call.
Insurer or Pharmacy Benefit Manager (Payers)
Group of colleagues in a meeting on their laptops and laughing.

In current prior authorization (PA) practices private payers (insurers or pharmacy benefit managers (PBMs)) reimburse a prescribed medication on the condition of satisfactory medical evidence from a patient and their prescriber according to criteria established by payers. In a fully electronic prior authorization (ePA) process claims are made and adjudicated online. On this site you will find more details on current prior authorization practices and what can be implemented now as a first generation ePA solution in Canada to ease the current burden on prior authorization stakeholders.

What People Say

Contact SPA

Contact the SPA team with any questions, comments, to find out more, get involved, or for sponsorship of this important initiative. Plus you can register to receive upcoming blogs, podcasts, and for notification about upcoming webinars.

Blogs | Podcasts

Simplify Prior Authorization – now on Facebook!
March 06, 2024

Simplify Prior Authorization – now on Facebook!

Follow our new Facebook page, where we will be providing resources and insight into the prior authorization claims process for patients.

Minimizing Disruptions to Continuity of Care
February 26, 2024

Minimizing Disruptions to Continuity of Care

In the fifth of our six-part series examining the prior authorization (PA) process in Canada vs. the U.S. we address the importance of the continuity of patient care.

Contact Us / Register

Thank you to our financial supporters

Gold Sponsors

Logos for Amgen and Gilead

Silver Sponsors

Logos for AstraZeneca and Cencora / Innomar Strategies