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 July 14 released its calendar year 2026 proposed rule for the physician fee schedule. As required by…
Headline
The U.S. District Court for the Eastern District of Missouri July 11 granted a motion by the state to dismiss claims by AbbVie that the state’s 340B contract…
Headline
The Rural Hospital Excellence in Innovation Award honors rural hospitals that are leading the way in innovative, sustainable and community-centered care. If…
Headline
The AHA July 8 wrote in opposition to the “Patient Access to Higher Quality Health Care Act” (H.R. 4002), which would repeal current law banning the creation…
Headline
The AHA July 3 released the Health Care Plan Accountability Update for the second quarter of 2025. The update covers the latest developments in Medicare…
Headline
The Departments of Justice and Health and Human Services today announced the creation of the DOJ-HHS False Claims Act Working Group to combat health care fraud…