The Centers for Medicare & Medicaid Services should develop prior authorization measures for the Medicare Advantage Star Ratings Program to minimize care delays and protect patients from inappropriate care denials, AHA said in comments submitted today. “When instituted appropriately, prior authorization can help align patient care with health plan benefits and facilitates compliance with clinical best practices,” AHA wrote. “However, prior authorization requirements and processes vary widely, even among different health plan products offered by the same issuer, and can create dangerous delays in care delivery when not applied appropriately. They also can create confusion and burden for both patients and providers, leading to additional administrative costs for the health care system.”

Related News Articles

Headline
The Centers for Medicare & Medicaid Services yesterday released a fact sheet for state and local governments seeking Medicare, Medicaid or Children’s…
Headline
Over 1,750 Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs…
Headline
The Government Accountability Office today named three new members to the Medicare Payment Advisory Commission through April 2023. They are: Wayne…
Headline
The Centers for Medicare & Medicaid Services yesterday released early stakeholder insights from its Accountable Health Communities Model. The model tests…
Headline
The Centers for Medicare & Medicaid Services May 7 issued a final rule that implements the standards governing health insurance issuers and the Health…
Headline
A federal district court in Washington, D.C., today heard oral argument in the AHA’s legal challenge to the Centers for Medicare & Medicaid Services’ final…