New Medicare Program: Full List of Services That Will Need Prior Approval

[Ms. Toad]

40. It is not just AI needs to be destroyed - but the insertion of third party judgment (of any kind)

into the doctor patient relationship under original Medicare.

The Medicare program is designed to permit doctors to exercise their judgment, in consultation with their patients, for when covered procedures are required.

The solution - if a particular procedure should be excluded from Medicare - is to eliminate it as a covered procedure. Not to insert a third party speed bump in to the process.

One of these procedures is one I needed before I enrolled in Medicare. It was needed in connection with a very aggressive cancer. Had approval been required, it would have been denied. (I was under standard insurance at the time - and it was denied after the fact). Had the surgery been delayed while waiting for prior authorization, denial, and an appeal, the cancer (at that point doubling in 2-3 weeks) would likely have metastasized and I would be living with metastatic lung cancer or dead. And, yes, I'm in one of the states hit by this.

It is a travesty. Fortunately, it is only a few states and a few procedures. But it is the nose under the camel's tent to require prior authorization for procedures which are covered procedures under Medicare.