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Letter to the editor: Knocking Down Barriers to Long-Term Hospital Care
In a letter to the editor published March 3 by KFF Health News, Jim Prister, president and CEO of RML Specialty Hospital and chair of the AHA Post-Acute Steering Committee, urged Congress to address chronic underpayments and insurance barriers that are harming patient care and access to long-term care hospitals.
Survey finds prior authorization viewed as greatest hurdle in navigating health care
A KFF survey published today found that peopl
Study examines increase in states banning prior authorization in private health plans for OUD medications
A Health Affairs study published Nov. 3 examined an increase in states banning prior authorizations in private insurance plans for opioid use disorder medications.
AHA shares concerns, recommendations with CMS on WISeR model
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address multiple concerns.
AHA provides recommendations to HHS, CMS for insurers to adhere to prior authorization pledge
The AHA Sept. 29 sent recommendations to the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to help ensure insurance plans adhere to the agencies’ health insurer pledge to reform prior authorization processes.
CMS Innovation Center releases FAQ on prior authorization program pilot
The Centers for Medicare & Medicaid Services Innovation Center Aug. 12 released an FAQ on the Wasteful and Inappropriate Service Reduction Model, a six-year technology-enabled prior authorization program pilot.
CMS announces new prior authorization program pilot
The Centers for Medicare & Medicaid Services June 27 announced the rollout of a 6-year technology-enabled prior authorization program pilot.
HHS announces initiative with insurers to streamline prior authorizations
The Department of Health and Human Services June 23 announced an initiative coordinated with multiple health insurance companies to streamline prior authorization processes for patients covered by Medicare Advantage, Medicaid managed care plans, Health Insurance Marketplace plans and commercial plans.
GAO says CMS should target behavioral health services in prior authorization audits
The Government Accountability Office May 29 released a report recommending the Centers for Medicare & Medicaid Services target behavioral health services when auditing Medicare Advantage plans’ use of prior authorization.
Study finds 90% of Medicaid managed care plans cover at least one AUD medication without priority and quantity limits
A JAMA Network Open study published March 13 found that 90% of Medicaid managed care plans cover at least one alcohol use disorder medication without prior authorization and quantity limits.