The June 22 letter from Sen. Sherrod Brown (D-OH) and fellow lawmakers asked the Centers for Medicare & Medicaid Services (CMS) to approve reforms to the prior authorization process. The bipartisan group of 61 senators and 233 members of the House of Representatives signed the letter.
The House of Representatives approved legislation to change the authorization process in Medicare Advantage plans last year, but the Senate didn’t pass the bill before the congressional session ended. The administration’s reform plans include many of the key provisions of the legislation.
According to CMS, as of January, more than 30 million Americans were enrolled in Medicare Advantage plans, which provide supplemental coverage to traditional Medicare plans for senior citizens.
In a survey of more than 600 medical groups, 84 percent of respondents said prior authorization demands in Medicare Advantage plans have increased over the past 12 months, according to a report by the Medical Group Management Association (MGMA).
“Prior authorization requirements are routinely identified by medical groups as the most challenging and burdensome obstacle to running their practices and delivering high-quality care,” Anders Gilberg, MGMA’s senior vice president of government affairs, told Chief Healthcare Executive. “Increasing prior authorization requirements are detrimental to both practices and the patients they treat. The onerous methods of completing these requests, coupled with the increasing volume, is unsustainable.”
Read the letter to CMS here.
And don’t forget to visit opedge.com in July to read “CMS Issues New Rules for Prior Authorization Under the Medicare Advantage Program.” Until then, read “Nearly 300 members of Congress urge CMS to reform prior authorization in Medicare Advantage” in Chief Healthcare Executive to get the overall healthcare perspective.
