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GAO calls on CMS to continue prior authorization experiments
Modern Healthcare May 21, 2018
The CMS hasn’t moved to continue prior authorization experiments even though they could save Medicare billions of dollars, according to the U.S. Government Accountability Office.
Under the experiments, the CMS only pays for some items and services after providers and medical product suppliers have shown they complied with coverage and payment rules. The CMS uses prior authorization in Medicare for non-emergency ambulance rides, hyperbaric oxygen therapy, home health services and power wheelchairs.
The CMS may have saved as much as $1.9 billion thanks to prior authorization since it started the experiments in 2012.
But most of the experiments have ended or will end soon, and the CMS hasn’t announced plans to continue the vast majority of those efforts, the GAO...
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Topics: CMS, GAO, Govt Agencies, Health System / Hospital, Insurance, Medicare, Physician, Primary care, Provider