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CMS Finalizes Rules to Standardize Prior Authorization Processes
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 health care information.
AHA reiterates need to quickly finalize CMS prior authorization rule
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
AHA Urges CMS to finalize the Improving Prior Authorization Processes Proposed Rule.
AHA supports bill offering providers gold card exemptions under Medicare Advantage
In an Aug. 28 letter to House sponsors, the AHA voiced support for the GOLD Card Act of 2023 (H.R. 4968) that would exempt qualifying providers from prior authorization requirements under Medicare Advantage plans.
AHA Letter of Support for the GOLD Card Act of 2023 (H.R. 4968
AHA voices support of the GOLD Card Act of 2023 (H.R. 4968).
AHA Statement of Record for House Ways and Means Committee July 26, 2023
The American Hospital Association would like to provide feedback on sections of H.R. 4822, the “Health Care Price Transparency Act of 2023,” as well as H.R. 3284, the “Providers and Payers COMPETE Act.”
UnitedHealthcare identifies procedures no longer subject to prior authorization
UnitedHealthcare Aug. 1 published a list of procedures no longer subject to prior authorization effective either Sept. 1 or Nov. 1, 2023.
Letter on Notice of Proposed Rule Making Regarding Adoption of Standards for Prior Authorization Attachments
Our organizations urge CMS to not proceed with implementing the prior authorization (PA) attachment standards provisions of the NPRM due to conflicting regulatory proposals that would set the stage for multiple PA electronic standards and workflows and create the very same costly burdens that administrative simplification seeks to alleviate.
Members of Congress urge CMS to further streamline prior authorization
A bipartisan group of 233 representatives and 61 senators called on the Centers for Medicare & Medicaid Service to enhance its proposal to streamline prior authorization processes in Medicare Advantage, Medicaid and the federally-facilitated Marketplace to require real-time electronic decision-making for routinely approved services, responses for emergency procedures within 24 hours and additional transparency.
ACT NOW: House and Senate Hearings this Week to Focus on Key Hospital and Health System Issues
Several House and Senate committees will hold hearings this week on a variety of issues that affect hospitals and health systems.