Medicare Advantage Prior Authorization
Unusually high rates of prior authorization denials
The Department of Health and Human Services’ inspector general’s latest report found three specific Medicare Advantage plans had the highest denial rate for long-term care requests. “The range of denial rates from 8 percent all the way up to 80…
Prior Authorization Targeted by CMS Medicare
Under the guise of fraud and waste prevention, the Centers for Medicare & Medicaid Service (CMS),along with dozens of large healthcare insurance companies, have revealed forthcoming changes to the “Prior Authorization” process. Prior Authorization is a process used by various…
Improving Seniors’ Timely Access to Care Act
Improving Seniors’ Timely Access to Care Act of 2025 was reintroduced by U.S. Senators Roger Marshall, M.D. and Mark Warner on May 20, 2025. The bill if passed will establish requirements with respect to the use of prior authorization under…