Effects of a Psychotherapeutic Drug Prior Authorization (PA) Requirement on Patients and Providers: A Providers’ Perspective

This study describes the effects of a Texas Medicaid PA requirement for psychotherapeutic medications from the perspective of mental health care providers. Three focus groups were conducted and a content analysis was performed on the generated transcripts. Providers identified five categories of issues that are relevant to the PA process: (1) system/administrative factors; (2) costs/ outcomes; (3) prescribing issues; (4) evaluation criteria; and (5) patient–provider relationship and patient visit. Administrative burden and unintended patient outcomes were the most frequently reported issues related to PA. However, all five issues represent important factors that providers deal with when caring for patients with mental illness.