A bipartisan group of 233 representatives and 61 senators called on the Centers for Medicare & Medicaid Service to enhance its proposal to streamline prior authorization processes in Medicare Advantage, Medicaid and the federally-facilitated Marketplace to require real-time electronic decision-making for routinely approved services, responses for emergency procedures within 24 hours and additional transparency. They said adding these provisions would better align the rule with the Improving Seniors’ Timely Access to Care Act, House-passed legislation supported by the AHA to streamline prior authorization in the MA program, and urged CMS to quickly finalize the rule with these updates.

AHA also has urged CMS to quickly finalize the proposed rule, adequately enforce and monitor the requirements and test and vet any electronic standards before mandating their adoption.

Related News Articles

Headline
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on…
Headline
A JAMA study published yesterday analyzed the health characteristics of individuals projected to lose Medicaid coverage due to work requirements included in…
Headline
The Centers for Medicare & Medicaid Services Sept. 30 issued a memo, through the Health Plan Management system, finalizing the Medicare Advantage…
Headline
The Centers for Medicare & Medicaid Services Sept. 30 released guidance to states clarifying its interpretation of a provision that…
Headline
The AHA Sept. 29 sent recommendations to the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to help ensure…
Headline
The Centers for Medicare & Medicaid Services announced Sept. 26 that average premiums for Medicare Advantage and Part D would decline slightly in 2026.…