The AHA today praised a Centers for Medicare & Medicaid Services’ proposed rule that would remove inappropriate barriers to patient care by streamlining the prior authorization processes for the impacted health plans; however the association said it was deeply disappointed that CMS chose not to include Medicare Advantage plans, “many of which have implemented abusive prior authorization processes that act as a detriment to the provision of efficient and timely patient care,” in the rule.  

In addition, while hospitals and health systems appreciate CMS establishing timeframes for prior authorization decisions, AHA said the proposed timelines for urgent and non-urgent care are insufficient to protect patients and promote appropriate care.

“We urge CMS to reconsider the omission of MA plans and tighten the prior authorization decision timeframes in order to promote timely care and patient safety,” AHA said.

See the letter for AHA’s detailed comments on the proposed rule.

Related News Articles

Chairperson's File
Public
The recently enacted One Big Beautiful Bill Act will bring big changes to health care. AHA President and CEO Rick Pollack joined me for a Leadership Dialogue…
Headline
The Senate Health, Education, Labor and Pensions Committee yesterday voted 12-11 along party lines to recommend the confirmation of Brian Christine, M.D., to…
Chairperson's File
Public
This month Congress enacted the One Big Beautiful Bill Act — a sweeping package that contained many of President Trump’s legislative priorities on taxes,…
Headline
The Centers for Medicare & Medicaid Services July 15 issued a proposed rule that would increase Medicare hospital outpatient prospective payment system…
Headline
The AHA July 2 expressed support for the Resident Physician Shortage Reduction Act (H.R. 3890), bipartisan legislation that would add 14,000 Medicare-funded…
Headline
The House July 3 voted 218-214 to pass the final version of the One Big Beautiful Bill Act (H.R. 1), which enacts many of President Trump’s legislative…