Skilled Nursing News October 29, 2024
While prior authorization has a legitimate role in Medicare Advantage coverage, the practice has expanded to the point of negatively affecting care. This aspect of MA needs to be right sized, and likely through legislation, nursing home leaders said.
About 90%-plus of physicians, including those serving nursing home patients, have said that one or more of their patients have suffered significant harm because of delays tied to prior authorization, according to Dr. Bruce Scott, president of the American Medical Association (AMA).
“For 24% of these physicians, that delay has resulted in hospitalization, permanent disability or death – this is harming patients,” Scott said Tuesday at Sanford Health’s Rural Health Summit. Scott’s co-panelists were Zach Shamberg, president and CEO of the...
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