Medicare Advantage
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 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…
Learn about UnitedHealthcare's clarification on the hospital services review process for Medicare Advantage plans. Stay up-to-date.
AHA Jan. 5 voiced strong support for Centers for Medicare & Medicaid Services proposals to increase oversight and enhance consumer protections in the Medicare Advantage program for contract year 2025.
AHA comments on the CMS proposed rule for policy and technical changes to the Medicare Advantage program in contract year 2025.
CMS will conduct robust oversight to ensure Medicare Advantage organizations are complying with new access requirements for care and medications. Learn more.
The Centers for Medicare & Medicaid Services should require Medicare Advantage plans to submit additional data and the agency should publicly release the MA data it already collects, a bipartisan group of senators told the agency last week.
We appreciate the Medicare Payment Advisory Commission’s (MedPAC) November meeting discussions on Medicare Advantage (MA) prior authorization and network management. As MedPAC begins its discussions on payment adequacy for the Medicare program, we outline concerns about the impact that the shifting…
Certain Medicare Advantage organizations have issued policies for the coming year that AHA believes do not fully adhere to requirements in the MA final rule for calendar year 2024, the association alerted the Centers for Medicare & Medicaid Services Nov. 20.
The American Hospital Association is deeply concerned that these practices will result in the maintenance of the status quo where MAOs apply their own coverage criteria that is more restrictive than Traditional Medicare proliferating the very behavior that CMS sought to address in the final rule,…