Retrospective Denials

Medicare For All Explained

This is episode 29, “Retrospective Denials.”

My guest, Martha Gaines, is a 1983 cum laude graduate of the University of Wisconsin Law School and received her LL.M in 1993 from the same school. Her thesis is titled "I do make house calls--Effective Legal Representation From Our Clients' Perspective." Ms. Gaines is on the faculty of the National Criminal Defense College in Macon, Georgia and the New York State Defender's Association in Albany, New York.”

Ms. Gaines and several colleagues founded The Center for Patient Partnerships at the University of Wisconsin in September 2000. The Center trains students from the schools of Law, Medicine, Nursing, Pharmacy and Social Work to provide advocacy to cancer patients. Ms. Gaines teaches a Patient Advocacy course where students are joined in interdisciplinary teams that help cancer patients understand their diagnoses, get the information necessary to make critical treatment decisions, and support patient's efforts to obtain the treatment they need. The Center also conducts research about issues relevant to patient care and health care delivery from the patient's perspective.

Do not miss the episode as Ms. Gaines explains what retrospective denials are, and why they are especially harmful to patients.

Here is the link to the JAMA article mentioned in the podcast, "Changing the Game of Prior Authorization, The Patient Perspective."