Becker's Healthcare December 17, 2024
From CMS finalizing a rule aimed at streamlining the process to UnitedHealthcare launching a gold-card program, here are four key prior authorization updates Becker’s reported in 2024:
1. A new CMS rule aiming to streamline Medicare Advantage and Part D prior authorizations took effect Jan. 1. CMS issued the final rule in April 2023 and requires that coordinated care plan prior authorization policies may only be used to confirm the presence of diagnoses or other medical criteria and/or ensure that an item or service is medically necessary. It also requires coordinated care plans to provide a minimum 90-day transition period when a beneficiary undergoing treatment switches to a new MA plan. During this period, the new plan cannot require prior...
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