MedCity News September 16, 2022
Marissa Plescia

The bill sets requirements relating to the prior authorization process for Medicare Advantage plans. The House’s decision is supported by several healthcare advocacy organizations, including Better Medicare Alliance and the American Hospital Association. AHIP, however, neither criticized nor celebrated the passage.

Several senior healthcare advocates are coming out in support of the House of Representatives’ Wednesday decision to pass a prior authorization reformation bill for Medicare Advantage plans.

The bill, HR 3173, establishes three requirements: Medicare Advantage (MA) plans must create an electronic prior authorization program that meets certain standards, such as provide real-time decisions for requests on routine services; publish prior authorization information each year, including the percentage of approved requests and the average response time; and meet quality...

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Topics: Congress / White House, Govt Agencies, Insurance, Medicare Advantage, Provider, Regulations
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