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Let’s not forget why Prior Authorization exists - shitty doctors who get kickbacks from labs or imaging facilities (or who own them) sending patients there unnecessarily in order to embezzle unecessary payments from Medicare and Medicaid (or even commercial) plans, draining risk pools for their own gain.
There are no good guys in America.
Whats funny is you cite Medicare fraud. Medicare has a very short list of things they require preauths for. They are the easiest to work with. They do audits and if they spot any issues will take back all of the money. People are genuinely scared of that happening as it can be a lot at once if we did something wrong for a while.