Becker's Healthcare August 16, 2023
Maryland Rep. Mark Green has introduced a bill targeting prior authorization requirements in Medicare and Medicare Advantage, as well as prior authorization fixes for Medicare prescription drug plans.
The legislation would require that board-certified physicians in the relevant speciality are the ones making prior authorization determinations, according to an Aug. 15 news release from Mr. Green’s office. Medicare, Medicare Advantage and Medicare Part D plans would be directed to comply with requirements that restrictions must be based on medical necessity and written clinical criteria, as well as additional transparency obligations.
A number of bills aiming to reform...
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