Prior Authorization

Federal lawmakers and activists are turning up the heat again on Medicare Advantage, a month after 300 members of Congress told the federal agency that oversees the system to make it easier to manage.

Close to 300 members of Congress are urging federal regulators to do more to reduce burdensome Medicare Advantage requirements that can slow delivery of care to nursing home and other patients.

A Senate subcommittee Wednesday sent letters to the nation’s largest Medicare Advantage insurers, demanding they reveal internal documents that illustrate how they make coverage determinations.

As a rehab professional, is there anything more miserable than the gathering of stacks of documents and searching for records needed for pre-authorization? Awful scans, missing documents, and most importantly...

Providers demanding change to the Medicare Advantage program may soon get their wish after a House panel advanced a measure that would reform the program’s prior authorization process. 

Results show little progress across all five reform areas outlined in a 2018 consensus statement, the AMA has found.

A new report finds Medicare Advantage restrictions are also creating log jams in hospitals desperate to discharge patients to post-acute care and free up needed beds.

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A government crackdown on improper payments in federal programs, such as Medicare and Medicaid, cut wasteful payments by $17.6 billion in 2011, the Office of Management and Budget reported Tuesday. The...