Medicare Advantage
AHA's senior associate director of health insurance coverage discusses how commercial insurers are impacting patient care through their policies.
The Centers for Medicare & Medicaid Services (CMS) April 29 finalized its Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Program for Contract Year (CY) 2023.
CMS Friday finalized policy and technical changes to the Medicare Advantage and prescription drug benefit for contract year 2023.
The AHA continues to push back forcefully against MA plan policies that restrict or delay patient access to care, and add cost and burden to the health care system, while also contributing to health care worker burnout.
OIG found found 13% of coverage denials met Medicare coverage rules and 18% of payment denials met Medicare coverage and MA billing rules.
The final rule also codifies guidance on applying the changes beginning in contract year 2023.
The agency expects MA plans to see an average revenue increase of 8.5% under the final policies.
AHA encouraged the Centers for Medicare & Medicaid Services to work with Congress to require Medicare Advantage plans to waive prior authorization and other utilization management policies during public health emergencies, especially for hospitals transferring patients to post-acute care.
AHA encourages the Centers for Medicare & Medicaid Services to work with Congress to require Medicare Advantage plans to waive prior authorization and other utilization management policies during public health emergencies, especially for hospitals transferring patients to post-acute care.
The Centers for Medicare & Medicaid Services (CMS) Jan. 12 released a proposed rule for the Medicare Advantage program, which includes a request for information (RFI) on prior authorization for hospital transfers to post-acute care settings during a public health emergency.