Becker's Healthcare June 2, 2023
Here are five updates about prior authorizations that ASCs need to know:
1. In March, insurer UnitedHealthcare announced changes to its prior authorization rules for certain GI procedures that were set to go into effect June 1. The night before changes were supposed to take effect, UHC reversed its plans, opting instead for a “gold card” program.
2. In December, CMS submitted a 134-page proposal designed to improve prior authorizations for Medicare and Medicaid patients through automating the process and improving workflows. Some surgeons are still skeptical that CMS’ proposals will become reality and are waiting to see actual changes and results.
3. Payers are constantly changing prior authorization rules, keeping physicians and physician staff on their toes...
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