What Does PAFA and Its Four Guiding Principles Mean to You?

The goal of the Prior Authorization Framework and Accreditation (PAFA) Program is to improve the prior authorization (PA) process in Canada by accrediting payers who adopt efficient administrative practices, including electronic prior authorization (ePA).

The first step and cornerstone to improving prior authorization is the four guiding principles created by PAFA. PAFA’s four guiding principles are:

1. Communication: Ensuring clear, patient-centric communication with accessible, non-proprietary information, including online lists of PA medications.
2. Transparency and Fairness: Advocating for transparent PA processes, where stakeholders understand claim flows, denials, and appeals, and patients receive timely information to minimize care disruptions.
3. Consistency: Promoting uniform, evidence-based decision-making to ensure equitable patient access and reduce disparities.
4. Efficiency: Streamlining the PA process through technology, reducing delays, and continuously improving workflows, including the adoption of ePA systems.

PAFA is calling on payers to become members of PAFA and demonstrate their commitment to PAFA’s four guiding principles for prior authorization. Payer members will be recognized by PAFA, and by advisors and plan sponsors for their commitment.

PAFA is also calling on advisors, plan sponsors, and other industry stakeholders to support PAFA by becoming associate members of PAFA, encouraging payers to adopt the PAFA’s guiding principles and recognize payers who do so.

Membership and associate membership are available now to show your organization’s support of clear, fair, consistent and efficient prior authorization in Canada. Learn more and apply for PAFA membership.

Accreditation opportunities for payers will be available in 2025.

PAFA is a Canadian non-profit that is committed to improvements in prior authorization in Canada and the recognition of public and private payers who become accredited. Members and associate members are eligible to participate in our Advisory Board and Accreditation Panel. Find out more from denisebalch@priorauthframework.ca or call 905 220 4260.