Draft Bipartisan Letter To CMS: Tell MA Plans They Can't Use Prior Authorization To Limit Services

By Michelle M. Stein / August 10, 2018 at 5:46 PM
Reps. Phil Roe (R-TN) and Ami Bera (D-CA) are asking colleagues join them on a letter asking CMS Administrator Seema Verma to inform Medicare Advantage plans they can't use prior authorization to inhibit access to services. The letter follows agency meetings with specialty groups, who also worry prior authorization is limiting care, and a legal analysis that says the extensive use of prior authorization by MA plans has imposed legally problematic barriers to medically necessary services. However, that analysis hinges...

Not a subscriber? Sign up for 30 days free access to exclusive, detailed reporting on drug pricing reforms, Medicaid policy, FDA news and much more.