Prior Authorization
American Hospital Association (AHA) resources on health care insurance prior authorization, the impact of insurers' delays and rejections on patients, and the cost of these delays to hospitals and health systems.
The Council for Affordable Quality Healthcare Feb. 11 released a report highlighting how the health care industry can save $20 billion by transitioning from manual to electronic workflows.
An analysis by KFF released Jan. 28 found that Medicare Advantage insurers made nearly 50 million prior authorization determinations in 2023. The finding reflects continued year-over-year increases from 2022 (42 million) and 2021 (37 million) as more people have enrolled in MA. KFF also found that…
The AHA Dec. 17 released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and regulation of private health insurers, as well as other resources from the last quarter.
A report released Oct. 17 by the Senate Homeland Security Committee’s investigative subcommittee scrutinizes some of the nation's largest Medicare Advantage insurers for their use of prior authorization and high rates of denials for certain types of care.
There will always be administrative costs associated with operating a hospital. But the lion’s share of a hospital’s resources should be devoted to doing what hospitals do best: provide safe, accessible and exceptional patient care to anyone who needs it.
The AHA Sept. 17 urged the Department of Health and Human Services’ Office of Inspector General to further scrutinize policies and practices by certain Medicare Advantage Organizations (MAOs) that impede patient access to post-acute care and circumvent rules designed to ensure access and coverage…
The AHA applauds the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) for your recently announced review of Medicare Advantage Organizations' Use of Prior Authorization for Post-Acute Care.
More than 46 million prior authorization requests were submitted to Medicare Advantage insurers in 2022, according to KFF analysis released Aug. 6 examining data submitted by MA insurers to the Centers for Medicare & Medicaid Services on prior authorization requests, denials and appeals from…
UnitedHealth Group Aug. 1 announced the creation of a gold card program for qualified practices. Under the program, the practices that earn gold card status will not be required to submit prior authorization requests for certain medical, behavioral and mental health services.
Data-driven strategies to combat Medicaid managed care organization (MCO) denials and ensure quality health care delivery for Medicaid enrollees.