AHA urges CMS to address prior authorization issues affecting Medicare Advantage patients

The AHA yesterday urged the Centers for Medicare & Medicaid Services to revise and reissue recent proposed regulations streamlining prior authorization requirements within certain coverage programs; consider additional regulations to limit care delays; and conduct oversight and enforcement for plans who have demonstrated problematic prior authorization usage in the past. Most importantly, the AHA urges the agency to apply the proposed prior authorization policies to Medicare Advantage Organizations. AHA’s letter also details how CMS can better protect MA plan enrollees from other problematic health plan actions.