Prior Authorization Framework and Accreditation (PAFA)
A Canadian non-profit founded in 2024 to promote and recognize positive change in payer claims administration practices for specialty drugs that require prior or special authorization (PA).
Prior Authorization Framework and Accreditation (PAFA)
A Canadian non-profit founded in 2024 to promote and recognize positive change in payer claims administration practices for specialty drugs that require prior or special authorization (PA).
Prior Authorization Framework and Accreditation (PAFA)
A Canadian non-profit founded in 2024 to promote and recognize positive change in payer claims administration practices for specialty drugs that require prior or special authorization (PA).
Prior Authorization Framework and Accreditation (PAFA)
A Canadian non-profit founded in 2024 to promote and recognize positive change in payer claims administration practices for specialty drugs that require prior or special authorization (PA).
PAFA Membership
Payers can become members to get involved and shape the future of the PAFA Program. Payer members can also apply to join the Advisory Board and/or apply for PAFA accreditation at one or both of two levels:
- Administration excellence
- Electronic Prior Authorization – part A and B
Find out more in the Prior Authorization Framework and Accreditation Program Guide
The Guide includes the four fundamental values that the accreditation framework is based on and the four guiding principles. It also contains details of the Industry Framework on which accreditation is awarded.
There are two levels of accreditation open to payers:
- Administration Efficiencies – is available to all payers now who adjudicate prior authorization claims even if it is a manual process.
- Electronic Prior Authorization (ePA) – is available to payers that have automated adjudication or who accept electronic prior authorization claims completion and submission.
Become a PAFA Member
Whether you are a payer, advisor, patient support program, employer, plan sponsor, association or patient group your organization can be a member or associate member.
- Payer membership
- Associate membership – all non-payers
We are pleased to welcome the following member and associate member organizations:
Accreditation
Payers can now apply for PAFA accreditation. For details on how to apply for accreditation and assess whether your organization is ready to apply, our Advisory Board and Accreditation Panel have prepared an Accreditation Companion and Checklist.
When you are ready to apply for accreditation, please contact denisebalch@priorauthframework.ca with the subject line Ready to apply for PA Accreditation for your unique link and access code to online accreditation forms. Questions? Just contact Denise Balch by email.
Administration Efficiencies (AE)
Electronic Prior Authorization (ePA)
Gold Certification (AE and ePA)
Annual Reporting
PAFA will publish an annual report on PA in Canada. Members and associate members have an opportunity for input and a more in-depth analysis than is publicly available.
The current PA environment
Industry survey results
Updates and changes to PAFA
Accredited payers
Membership and associate membership
Management and oversight