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news
September 25, 2024
A precarious waiting game: Prior authorization and patient care
By DR. EDGAR ?BUD? BOYD PRESIDENT OF THE OKLAHOMA STATE MEDICAL ASSOCIATION

“Prior authorization.” Largely unknown until a few years ago, it’s quickly become one of those insurance terms that’s sure to give any medical provider or patient an instant headache.

Insurance companies require prior authorization for certain procedures, tests and medications. In order to approve treatment, the insurance company puts a hold on a claim while it is reviewed on its end before an approval or a denial is issued. This process was implemented to keep costs down and limit egregious claim approvals, all to the benefit of the insurance company.

As our system stands, insurance companies are a necessary part of our health care model, but at the end of the day, they’re for-profit entities. Their cost-saving measures tend to outweigh what’s best for patients, and that’s when problems arise. Unfortunately, it’s happening all too often.

As a physician, I can attest that prior authorization has been a pain point for me—and, more importantly, for my patients—for many years. Which treatments require prior authorization isn’t always clearly spelled out, leaving physicians and patients to navigate a minefield of authorization-related delays and denials. Physicians and staff routinely spend hours on administrative tasks related to prior authorization, like submitting documents and following up on approvals, spending precious patient time listening to the insurance companies’ hold music. It’s frustrating and can be dangerous as delays for patients with time-sensitive treatment plans can be life threatening.

Now, AI has crept into the prior authorization process. Patients have long been denied access to medical care as a result of prior authorization reviews, but these days, a computer may be issuing the denial. There’s not even a human involved in the process, much less a doctor. This is unacceptable.

The tide is turning, but there’s still much work to be done: Prior authorization has been recognized as an issue by lawmakers, and in May of this year, the Ensuring Transparency in Prior Authorization Act was signed into law. When it goes into effect in 2025, the law will establish more stringent and transparent timeframes and policies for prior authorizations. Insurance companies will be required to modernize their authorization systems, publish prior authorization requirements online and require licensed medical professionals to make denials, just to name a few.

This is a win for all Oklahomans. It ensures patients receive timely, appropriate treatment, as determined by medical professionals. Plus, it allows physicians— many of whom are already stretched thin, especially in rural areas—to spend more time treating patients and less time on administrative runaround.

At the end of the day, our patients trust medical professionals with their lives, not insurance companies. Red tape has no place in health care.

Edgar Morris Boyd, M.D. is an otolaryngologist in Muskogee, where he practices at the Warren Clinic Saint Francis Health System. He is president of the Oklahoma State Medical Association.

Eufaula losing two prominent citizens
A: Main, news
Eufaula losing two prominent citizens
By JERRY FINK MANAGING EDITOR 
December 31, 2025
Robyn and Randy Burris, two of Eufaula’s leading citizens who are shining examples of what it means to be community spirited, will be leaving in January for Sheridan, Ark., just south of Little Rock. ...
2025: Year in review
A: Main, news
2025: Year in review
By JERRY FINK MANAGING EDITOR 
December 31, 2025
The year 2025 was an eventful one for Eufaula. Many local residents joined forces to help defeat the creation of a wind turbine farm in the county. The Muscogee Nation opened its Lake Eufaula Casino i...
A: Main, news
The subsidy cliff: What the end of ACA subsidies means for McIntosh County
By Staff Reports 
December 31, 2025
Congress has allowed the Affordable Care Act (ACA) subsidies, which significantly lowered premiums for millions, to expire on December 31, 2025. There is no stopgap and no extension. While Washington ...
Steele pleads guilty to robbery
A: Main, news
Steele pleads guilty to robbery
By JERRY FINK MANAGING EDITOR 
December 31, 2025
Dallas Allen Steele, 38, Checotah, has pled guilty to robbery with a weapon and possession of a firearm after a former felony conviction. On Dec. 10, Associate District Judge Brendon Bridges sentenced...
WMU Alliance prepare gifts for nursing home
news
WMU Alliance prepare gifts for nursing home
December 31, 2025
The Woman’s Missionary Union (WMU) recently wrapped gifts for residents of Lakeview Nursing home. Woman’s Missionary Union (WMU), founded in 1888, is the largest Protestant mission’s organization for ...
Merit vs. equity in college football
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Merit vs. equity in college football
December 31, 2025
Now that the playoffs are set, it’s worth taking a moment to understand the flaws and biases built into the college football ranking system. While fairness may be an interesting word, I’m someone who ...
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