As a neurologist, I have the privilege of helping patients manage complex diseases like multiple sclerosis (MS)—a condition that can cause lasting damage to nerves, affecting vision, balance, mobility and cognitive function. For my patients, every moment counts. Yet, the single most frustrating obstacle I face in providing timely care is not the disease itself—it’s the burden of prior authorization requirements imposed by insurance companies.
Every day, I see how unnecessary delays in treatment caused by cumbersome prior authorization barriers affect my patients. These delays are not just inconvenient—they are dangerous. For people with progressive diseases like MS, every missed day of medication and care increases the risk of irreversible damage.
All too often, this delay is the difference between managing a disease and watching it take hold and lead to permanent disability or even death.
Let me share the story of one of my patients. She moved to Alabama from another state, where she had been managing her MS with medication. This allowed her to maintain a good quality of life. She simply needed to continue her current care, and at our first visit, I renewed her prescription. Simple enough, right? That’s when things started to unravel.
We faced multiple issues with getting her medication approved. Due to prior authorization delays and lack of communication from her insurance provider, what should have taken days turned into weeks, and weeks became months.
As a result, my patient ran out of the medication that had been keeping her MS under control. Predictably, her condition worsened. By the time she came to see me again, a few short months later, she was in a wheelchair. She had gone from being ambulatory and managing her disease, to facing a life forever altered by this unnecessary and infuriating delay in her care because of prior authorization requirements. Over a year has now passed, and she remains confined to that wheelchair.
What makes this even more heartbreaking is that her case is not unique. Prior authorization delays are not an anomaly. They are a routine part of navigating today’s overly complex healthcare system. Insurance companies claim that these policies are in place to ensure the appropriate use of treatments, but the reality is that more than 90% of prior authorization requests are eventually approved.
So, what’s the point of these delays? Are they waiting for patients or their doctors to give up? Are they trying to save a small amount of money, only to end up paying more when a patient’s condition worsens and healthcare needs increase?
It’s time for a change. We must streamline the prior authorization process—simplify it, make it faster, and make it work for patients, not against them.
The current system robs healthcare providers and their staff of time and resources that could be better spent on patient care. More importantly, it harms patients by forcing them to endure unnecessary delays in treatment.
That’s why I’m lending my voice to a coalition of Alabama physicians, nurses and patients who want to fix prior authorizations. We seek common sense changes that will benefit patients and ensure they receive the timely care they need, changes like quicker response times from insurers and an end to repeat prior authorizations for patients who suffer with chronic conditions.
This coalition of patient advocates has launched an online platform at ALFixPriorAuth.com where Alabamians can share their own stories about how insurance companies’ prior authorization roadblocks delayed their care. These stories will be crucial in driving needed changes forward.
We can no longer let paperwork and red tape stand in the way of effective medical care. Patients like mine deserve better. They deserve a healthcare system that works for them, not one that puts obstacles in their path. We need reform, we need to fix prior authorization, and we need it now—before more lives are irreversibly altered by preventable delays.
Dr. William Kilgo serves as the Director of the Neuroimmunology and MS Clinic at USA Health, one of the only clinics recognized in the state of Alabama by the National Multiple Sclerosis Society as a Partner in MS Care. He is an active member of the American Academy of Neurology with a special interest in advocacy and public policy.
