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.
People enrolled in Medicare Advantage are more likely than those in traditional Medicare to report delays in care due to needed insurance approvals, according to a survey released Feb. 22 by the Commonwealth Fund, with 13% of traditional Medicare enrollees reporting associated delays compared with…
The CMS Feb. 6 released a Frequently Asked Questions document pursuant to the calendar year 2024 Medicare Advantage final rule, which went into effect Jan. 1.
Andrea Preisler, AHA’s senior associate director of administrative simplification policy, explains why the recent final rule requiring Medicare Advantage, Medicaid and federally facilitated Marketplace plans to streamline their prior authorization processes should help reduce the burden on…
The CMS Jan. 17 finalized new regulations intended to streamline and reduce the burden associated with health plan prior authorization processes.
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.
The Centers for Medicare & Medicaid Services (CMS) Jan. 17 finalized new regulations intended to streamline and reduce the burden associated with health plan prior authorization processes, promote greater transparency into medical necessity criteria, and improve the electronic exchange of…
The Centers for Medicare & Medicaid Services Jan. 17 released a final rule requiring Medicare Advantage, Medicaid and federally facilitated Marketplace plans to streamline their prior authorization processes. AHA has urged the agency to finalize the rule to alleviate provider burden and ensure…
Rick PollackPresident and CEOAmerican Hospital AssociationJanuary 17, 2024
AHA urged the Centers for Medicare & Medicaid Services to quickly finalize a proposed rule that would require Medicare Advantage, Medicaid and federally facilitated Marketplace plans to streamline their prior authorization processes.
AHA Urges CMS to finalize the Improving Prior Authorization Processes Proposed Rule.