Prior Authorization

Jan 14, 2023
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.
Dec 7, 2022
The Centers for Medicare & Medicaid Services (CMS), proposed new regulations that would streamline and reduce the burden associated with health plan prior authorization processes and improve the electronic exchange of health care information.
Dec 6, 2022
The Centers for Medicare & Medicaid Services tonight released a proposed rule that would require Medicare Advantage, Medicaid and federally-facilitated Marketplace health plans to streamline processes related to prior authorization.
Dec 6, 2022
The AHA commends CMS for taking important steps to remove inappropriate barriers to patient care by streamlining the prior authorization process for some health insurance plans. Hospitals and health systems especially appreciate that CMS included Medicare Advantage plans in these requirements, as…
Nov 4, 2022
The AHA appreciates the opportunity to comment on the Centers for Medicare & Medicaid Services’ (CMS) “Make Your Voice Heard” Request for Information (RFI) on promoting equity and efficiency in CMS programs. As requested in the RFI, we submitted our key recommendations using CMS’s electronic…
Nov 1, 2022
Certain commercial health insurer policies and administrative practices delay patient care, overburden clinicians and withhold critical payments from providers.
Sep 23, 2022
AHA today released the special edition podcast “How Prior Authorizations Can Harm Patient Care,” addressing how some health plan prior authorization policies delay or deter necessary patient care, potentially putting patients’ lives at risk.
Sep 23, 2022
In medical care, prior authorization was originally intended to ensure patients received appropriate care that was in line with tested methodologies. Today, “prior authorization” has become a dreaded term…often signaling delayed care and undue financial burdens posed to patients and care providers…