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Health Plan Accountability Update: July 2023
CMS released a final rule that would increase oversight of Medicare Advantage plans and better align them with Traditional Medicare.
Health Plan Accountability Update - October 2024
CMS released a new complaint process for providers seeking assistance from the agency in resolving Medicare Advantage claims issues.
Health Plan Accountability
Commercial health plan abuses must be addressed to ensure fair coverage for patients and providers. The AHA has worked to hold health plans accountable through letters, statements, white papers, member updates and earned media.
Addressing Commercial Health Plan Challenges to Ensure Fair Coverage for Patients and Providers
This report documents the American Hospital Association’s (AHA) findings related specifically to prior authorization and payment delays and denials. This work is informed by two large surveys of hospitals, as well as interviews and group discussions with hundreds of hospital and health system leaders.