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

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 House Ways and Means Subcommittees on Health and Oversight held a joint hearing today to discuss lessons learned, challenges and opportunities to improve…
Headline
The Congressional Budget Office today released its estimate of the budgetary effects of the One Big Beautiful Bill Act, as enacted. CBO projects the law will…
Headline
The Centers for Medicare & Medicaid Services July 17 issued two letters to states regarding policies on continuous eligibility and workforce initiatives.…
Headline
Sen. Josh Hawley, R-Mo., July 15 introduced legislation that would repeal some of the Medicaid funding reductions included in the recently enacted One Big…
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…