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.

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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 Advisor
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Patient Support
Program
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Insurer or Pharmacy Benefit 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. 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

“The SPA website has been a great resource for me to share with new professionals in the industry as a way of providing them a comprehensive 101 of the Prior Authorization landscape, its stakeholders, and their common challenges.”

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

Improving the Reimbursement Road Map
January 22, 2024

Improving the Reimbursement Road Map

In this podcast, Alan Birch shares why improving access points to reimbursement and the reimbursement process is critical to improving time to treatment and ultimately patient outcomes.

Improving the Road Map to Patient Support Programs and Reimbursement
January 09, 2024

Improving the Road Map to Patient Support Programs and Reimbursement

As a former Oncology Drug Access Navigator (DAN), I understood that my patients needed treatment urgently for their cancer, and they didn’t have time to wait for it […]

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