The Prior Authorization Framework and Accreditation (PAFA) Program is pleased to announce the launch of the Accreditation Application Companion and Checklist for payers with an interest in learning more about the accreditation process before they apply for accreditation. The PAFA’s September 23, 2025, webinar on Navigating the Changing Prior Authorization Landscape included an overview of the Companion and can be viewed here. Presenters include Denise Balch, PAFA’s Executive Director, and guest presenter and advisory board member Dr. Imtiaz Khan, Rheumatologist, and Chair of the Private Payers committee for the Ontario Rheumatology Association. PAFA advisory board members Abigail O’Neill, VP at Mosey & Mosey and John Anacleto, Anacleto Consulting joined presenters for a panel discussion.
What is PAFA Accreditation?
PAFA accreditation recognizes those payers, both public and private, who have implemented administration efficiencies in the processing of prior authorization claims. There are three accreditation levels:
- Administration Efficiencies
- Electronic Prior Authorization (ePA) – Parts A and B
- Gold Accreditation (for those who have achieved levels 1 and 2)
The Accreditation Application Companion
The Accreditation Application Companion provides valuable information for any payer with an interest in pursuing accreditation and who wants to evaluate their readiness to apply.
The Companion reviews the three levels of accreditation, and it also addresses the benefits of membership and accreditation, details of the application process, privacy and confidentiality, and frequently asked questions. Included is an Accreditation Checklist for payers to evaluate their readiness to apply for accreditation.
Membership First
Whether a payer is ready or not to apply for accreditation, they are encouraged to become a member and get involved. Once they are members, payers can not only apply for accreditation, they can also apply for one of two payer seats on PAFA’s advisory board. Plus, all payer members receive regular updates and have input into the annual PAFA report and in PA in Canada surveys.
The PAFA’s payer membership form is available online at the PAFA website.
When a payer member is ready to apply for accreditation, they should contact denisebalch@priorauthframework.ca for their unique secure link and access code to online accreditation forms.
Accredited payers will be recognized on the PAFA website, in promotional communications, and at PAFA’s online and in-person events, including in-person accreditation awards.
Is There a Role for Non-Payers?
Yes. Non-payers are encouraged to become associate members of PAFA. Associate members will receive regular updates, are eligible to apply for one of seven non-payer seats on PAFA’s advisory board and may be eligible to apply for one of five seats on the accreditation panel.
The associate membership form is available online at www.priorauthframework.ca/#membership.
What is PAFA?
PAFA is a Canadian non-profit in operation since 2024. The primary goals of the PAFA Program are to:
- Grow a membership of payer and non-payer stakeholders to support change in prior authorization,
- Motivate payers to review and if necessary, improve their prior authorization claims processes and practices to introduce efficiencies that benefit all stakeholders,
- Recognize payers who achieve the processes and practices in the Prior Authorization Framework and Accreditation Program through accreditation and recognition.
PAFA will also release an annual report on prior authorization. Look out for the 2025 Prior Authorization Survey in Canada which will be launched this Fall.
PAFA is managed by a Board of Directors, a Framework and Accreditation Advisory Board (Advisory Board) that is made up of a cross section of seven industry stakeholders and two payer members, and an Accreditation Panel made up of five members who are non-payer industry leaders. A list of those who are part of PAFA’s management and government structure can be found on the PAFA website.
Questions? Contact denisebalch@priorauthframework.ca.