HealthLeaders Media July 13, 2022
The American Hospital Association (AHA) urged Congress to streamline Medicare Advantage plans’ prior authorization requirements in lengthy letter.
The AHA submitted a letter to the House Energy and Commerce Oversight and Investigations Subcommittee calling for greater congressional oversight to protect access to care for Medicare Advantage (MA) beneficiaries.
The letter urged Congress to support legislation for the following:
- Streamline MA plans’ prior authorization requirements
- Prohibit MA plans from using more restrictive medical necessity and coverage criteria than traditional Medicare
- Establish a provider complaint process and enforce penalties for plans that fail to comply with federal rules
- Clarify states’ role in MA plan oversight
“Inappropriate and excessive denials for prior authorization and coverage of medically necessary services is a...
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