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.
AHA Comments on the Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) Dec. 6 released a proposed rule to improve the electronic exchange of health care data and streamline processes related to prior authorization. The proposed rule places new requirements on Medicare Advantage (MA) organizations; state…
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.
The Centers for Medicare & Medicaid Services (CMS) Dec. 14 released its proposed Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Program for Contract Year (CY) 2024. The proposed rule would increase oversight of Medicare Advantage (MA) plans and…
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.
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.
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…
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…
Certain commercial health insurer policies and administrative practices delay patient care, overburden clinicians and withhold critical payments from providers.
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.