Prior Authorization Blogs, Podcasts, and Webinars

The American Hospital Association hosted a webinar featuring representatives from the Centers for Medicare & Medicaid Services (CMS) and Epic to discuss federal requirements for electronic prio

As major provisions of the 2024 Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization final rule take effect next year, hospitals and health systems should begin preparing for changes to prior authorization workflows, payer interactions and information exchange.

Unacceptably, millions of Americans are struggling with healthcare costs. Many have chosen to skip prescriptions or other needed care because of concerns about costs; 4 in 10 Americans have medical debt.

There will always be administrative costs associated with operating a hospital.

In this conversation, Andrea Preisler, Jennifer Cameron, and David Jacobson, M.D., discuss what the new prior authorization rule means for making sure clinicians can do what they do best: taking care of their patients.

Overview of the Advancing Interoperability and Improving Prior Authorization Processes Final Rule webinar and powerpoint.

For many people, choosing an MA plan is a life-changing event and a significant act of trust, counting on the payer they selected to provide the pre-agreed upon coverage for either current medical needs or those that may arise.

AHA staff will summarize the key provisions of the Medicare Advantage proposed rules, provide an opportunity for Q&A, and solicit hospital and health system input into AHA commentary and advocacy.

In medical care, prior authorization was originally intended to ensure patients received appropriate care that was in line with tested methodologies.

Medicare Advantage or MA Plans are another way for beneficiaries to get Medicare Part A and Part B coverage delivered through private insurance companies.

The AHA is committed to further identifying ways to improve health care system efficiency while providing the highest quality of care.