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.
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 (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…
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…
Rick PollackPresident and CEOAmerican Hospital AssociationJanuary 17, 2024
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.
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 voices support of the GOLD Card Act of 2023 (H.R. 4968).
UnitedHealthcare Aug. 1 published a list of procedures no longer subject to prior authorization effective either Sept. 1 or Nov. 1, 2023.
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…