GAO report finds lack of oversight on Medicaid managed care plans’ prior authorization requirements for children

American Hospital Association May 30, 2024

A report released May 29 by the Government Accountability Office found a lack of state oversight on Medicaid managed care plans’ use of prior authorization for children’s health care services. It found that none of the states sampled reviewed a representative sample of commercial Medicaid plans’ claim denials or used data to assess “the appropriateness of the full scope of plans’ prior authorization decisions.” The study underscores concerns that Medicaid managed care plans may implement policies that...

Today's Sponsors

Today's Sponsor