The Government Accountability Office May 29 released a report recommending the Centers for Medicare & Medicaid Services target behavioral health services when auditing Medicare Advantage plans’ use of prior authorization. CMS said it currently does not target behavioral health services because they make up a small percentage of MA services, the report said.     

The report describes selected MA organizations’ prior authorization requirements and use of internal coverage criteria for prior authorization decisions on behavioral health services. It also examines CMS’ oversight of the use of internal coverage criteria, among other issues. GAO said that CMS “would take the recommendation under advisement in the future.” 

Related News Articles

Headline
Rebecca B. Chickey, MPH, AHA’s senior director, behavioral health services, closes Mental Health Awareness Month with a blog highlighting what the AHA and…
Headline
Adrienne Coopey, D.O., a child and adolescent psychiatrist at the West Virginia University Rockefeller Neuroscience Institute, discusses how a fully virtual…
Blog
Even before the COVID pandemic, the mental health and wellness of our young people was failing. The pandemic exacerbated the crisis and made it difficult for…
Headline
The Dr. Lorna Breen Heroes’ Foundation has recognized 50 licensure boards and 635 hospitals for changing invasive and stigmatizing mental health questions in…
Headline
The Centers for Medicare & Medicaid Services May 21 announced it will immediately begin annual audits of all Medicare Advantage plans and work to clear a…
Headline
Overdose deaths in the U.S. fell 26.9% last year to 80,391, according to estimates from the Centers for Disease Control and Prevention. The agency reported…