AGA Benefit Solutions is proud to become the newest member of the Prior Authorization Framework and Accreditation (PAFA) program, a Canadian non-profit founded in 2024 to promote and recognize positive change in payer practices for specialty drugs that require prior or special authorization (PA).  

Each year, dozens of new drugs enter the market, with effectiveness varying based on a patient’s condition and treatment history. Commonly required by public and private insurance plans, PA ensures standard treatments are considered before resorting to specialty drugs. PA helps manage costs while safeguarding access to care, but it is acknowledged that the process could be streamlined and more transparent for patients and providers. 

As one of the lead third-party payers (TPPs) in Canada, AGA wants to contribute to the evolution of prior authorization practices and support developments in this field. As such, Massimo Nini, Senior Vice President, Consulting, Underwriting and Actuarial Services at AGA, has also been appointed to PAFA’s Advisory Board. The Board is responsible for updates to PAFA’s Guiding Principles, the Framework, Accreditation applications, the first PA industry survey to evaluate current practices and experiences with prior authorization, launching September 2025, and reporting. 

“AGA is proud to be one of the pioneers in promoting the improvement of prior authorization processes and practices in Canada as PAFA’s most recent member firm,” said Mr. Nini. “PAFA’s mission aligns with our brand promise to provide ‘the best of people and technology’ to plan members and administrators–and that includes contributing to make PA processes easier, faster and cost-effective for members, insurers and health care providers.” 

“We are very pleased to welcome AGA as a PAFA member. I believe it is critical for this initiative’s success to have the support and contribution of payers, advisors and other stakeholders in the prior authorization process. AGA has demonstrated their commitment to fostering improvements in the prior authorization through their membership. We look forward to their contribution on the Advisory Board and to PAFA’s future success,” said Denise Balch, Executive Director and Founder, Prior Authorization Framework and Accreditation Program Inc. 

About PAFA 

The Prior Authorization Framework and Accreditation (PAFA) Program has developed a framework of efficiencies in prior/special authorization administration processes and practices that payers can refer to, and an accreditation program that recognizes payers who adopt PAFA efficiencies. The PAFA program has been developed in response to research findings that identify ongoing challenges within PA administration processes and practices in Canada and elsewhere.  

The goal of the PAFA Program is to recognize Canadian public and private payers who have adopted PA claims administration efficiencies and/or have implemented electronic prior authorization (ePA). PAFA promotes practices and processes that create efficiencies to improve the patient experience and the experiences of other PA stakeholders, reduce administration and time for claims processing, and improve the overall PA process. 

Canadian payers and advisors who would like to find out more about PAFA registration and accreditation can attend an informational webinar held by PAFA on September 23rd. To find out more and register: https://mailchi.mp/priorauthframework/pafa-webinar-42804

For more information about PAFA: https://priorauthframework.ca/