GAO: CMS Should Enhance Prior Auth Oversight In MCOs For EPSDT Services

CMS should provide clear guidelines for states to monitor Medicaid managed care plans' prior authorization decisions and must clarify whether plans can deploy the utilization management method in states that do not have those requirements to ensure that millions of beneficiaries aged 20 and under can access essential care they are entitled to, according to a recent Government Accountability Office (GAO) report that recommends the agency release guidance on the issue.