Fierce Healthcare February 2, 2024
A recommendation on the 2024 Measures Under Consideration list, brought forward by the Federation of American Hospitals (FAH), would add a quality measure in the Medicare Advantage (MA) star ratings system that mandates health plans to report certain prior authorization denial rates.
The Measures Under Consideration list gives feedback to the Centers for Medicare & Medicaid Services (CMS) on quality and efficiency measures the agency should consider and implement for government health programs. Released today, the list comment period is open through Feb. 16.
FAH is asking CMS to include a performance measure within the star ratings program of the percentage of initial MA plan denials that are upheld, overturned and partially overturned.
Their policy, titled Level 1 Upheld Denial...
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