Coming soon to your inbox! The Prior Authorization Framework and Accreditation (PAFA) Program, an exciting new development in the Canadian specialty drug landscape that will benefit patients, plan sponsors, and other prior authorization stakeholders, including payers.
Improving claims processes and practices for prior authorization (PA), sometimes called special authorization, is overdue. PAFA, a membership-funded Canadian nonprofit launching this Fall, is designed to engage PA stakeholders and recognize payers who implement efficiencies in PA without requiring them to compromise the proprietary aspects of PA.
The current paper-based PA claims process slows down claims preparation, submission and adjudication. Improving PA administration saves time for all stakeholders and patients receive their medications more quickly. When patients wait less time to start on medications, there is less presenteeism and time lost from work. Public payers in Ontario and British Columbia have adopted electronic prior authorization and are seeing the benefits.
The new PAFA Program includes membership for payers and non-payers, a prior authorization framework for payers, the opportunity for payer accreditation, and a chance to get involved. Advisors and plan sponsors will be able to familiarize themselves with the framework and know what to expect from payers, identify those payers who are members, and those who are accredited. Here is an overview:
Become a member or associate member and get involved! Members and associate members can get involved in PAFA by applying for a seat on the Framework and Accreditation Advisory Board. Associate members can also apply to sit on the Accreditation Panel.
Look out for the PAFA launch early this Fall!
Want to know more now, interested in membership or getting involved? Contact Denise Balch, executive director of PAFA at denisebalch@priorauthframework.ca or call 905 220 4260. You can also contact Denise through Simplify Prior Authorization or Connex Health.
Denise Balch
Project Manager, Simplify Prior Authorization
www.simplifypriorauth.ca
President, Connex Health Consulting
www.connexhc.com
905 220 4260
info@simplifypriorauth.ca
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In this blog, we focus on the important role of Drug Review Committees in maintaining a responsive and sustainable PA process through a regular review of existing medications as well as reviewing new medications that may be subject to prior authorization.
The interest in prior authorization is growing, which is driving more interest in reforming current practices and policies to become more efficient and drive down administration costs and reduce the time-consuming claims process.
Navigate the prior authorization (PA) process in Canada can be time consuming and confusing. Inefficiencies in the system create real challenges for all stakeholders—physicians, pharmacists, insurers, advisors, and most importantly, patients.
The Simplify Prior Authorization initiative is an advocate for education about prior authorization (PA) and improvement in current prior authorization practices and processes. If your organization is interested in finding out more, getting involved, or in sponsorship of this important initiative, please contact us via the link below.