Bipartisan bill looks to reform Medicare Advantage prior authorization

Healthcare Finance News May 14, 2021
Jeff Lagasse

Misuse can result in administrative burdens for providers and delay needed medical intervention, the bill’s authors said.

Congress is mulling changes to Medicare Advantage that would speed up the prior authorization process and mandate more transparency when health plans deny provider requests. The thinking behind the bill is that insurers sometimes use tactics that rein in healthcare costs, but also affect the level of care that providers are able to give.

The bipartisan legislation, the Improving Seniors’ Timely Access to Care Act, was introduced in the House of Representatives on Thursday.

Health insurers, including those that offer Medicare Advantage plans, require providers to obtain prior authorization for certain medical treatments or tests before they can provide care to their...

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