HealthLeaders Media January 11, 2024
CMS’ Medicare Advantage and Part D rule went into effect on January 1.
KEY TAKEAWAYS
– The rule requires Medicare Advantage plans to review prior authorization policies each year and remain in place for as long as a patient needs a service.
– Health systems that are struggling financially are stretched thin thanks to low reimbursement rates and high number of claim denials, leading some to consider terminating their Medicare Advantage contracts.
Will 2024 be the year providers get a handle on prior authorization struggles? With the Medicare Advantage and Part D rule going into effect on January 1, it’s too soon to tell.
The rule, issued by the Centers for Medicare & Medicaid Services (CMS), requires Medicare Advantage plans...
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