Simplify Prior Authorization

The Simplify Prior Authorization (SPA) initiative was formed in 2021 to advocate for improvements in the claims process for prescription drugs that require prior or special authorization (PA) by payers, usually insurers, before reimbursement is approved.

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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...

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Patient or
Patient Group
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Physician, Prescriber or Pharmacist
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Plan Sponsor or
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Patient Support
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Insurer or Pharmacy Benefits Manager (Payers)
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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.

The current prior authorization landscape has many challenges including the administrative and financial burden of the process. In a fully electronic prior authorization (ePA) process claims are made and adjudicated online. This is a goal for the future but not practical for first generation ePA in Canada. 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.

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

Patients and Prior Authorization for Specialty Drugs
January 13, 2023

Patients and Prior Authorization for Specialty Drugs

Featuring a conversation between Denise Balch, President, Connex Health and Rachael Manion, Executive Director, Canadian Skin Patient Alliance (CSPA).

Dermatology, Treatment Progression and Prior Authorization
June 10, 2022

Dermatology, Treatment Progression and Prior Authorization

Featuring a conversation between Denise Balch, President, Connex Health and Dr. Neil Shear, recently retired Dermatologist and Professor Emeritus, Temerty Faculty of Medicine: Dermatology, Clinical Pharmacology & Toxicology.

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