AHA To CMS: Stop MA Denials, Rework Prior Authorization

By Michelle M. Stein / May 23, 2022 at 2:33 PM
The American Hospital Association wants to meet with CMS to discuss ways to hold Medicare Advantage Plans accountable for what it alleges are inappropriate and illegal restrictions on beneficiary access due to prior authorization and other policies, and it says the HHS Office of Inspector General’s recent MA recommendations don’t go far enough. An HHS Office of Inspector General report found 13% of prior authorizations denied in a one-week period analyzed by the office met Medicare coverage rules and 18%...

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