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CMS-Aims-To-Streamline-Prior-Authorization
The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA).
In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing.
The Biden administration has shown a commitment to increasing oversight of MA plans and the proposed rule would better align MA with traditional Medicare with new provisions and policies.
Building on a separate proposal by CMS, the new rule strengthens prior authorization protections for patients and makes the administrative process more efficient. It would require that a granted prior authorization approval remain valid for an enrolee’s entire course of treatment, require MA plans to annually review utilization management policies, and require coverage determinations be reviewed by professionals with relevant expertise.
CMS-Aims-To-Streamline-Prior-Authorization
The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA).
In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing.
The Biden administration has shown a commitment to increasing oversight of MA plans and the proposed rule would better align MA with traditional Medicare with new provisions and policies.
Building on a separate proposal by CMS, the new rule strengthens prior authorization protections for patients and makes the administrative process more efficient. It would require that a granted prior authorization approval remain valid for an enrolee’s entire course of treatment, require MA plans to annually review utilization management policies, and require coverage determinations be reviewed by professionals with relevant expertise.