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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.
Report highlights how health care can avoid $20 billion in spending
The Council for Affordable Quality Healthcare Feb. 11 released a report highlighting how the health care industry can save $20 billion by transitioning from manual to electronic workflows.
KFF: MA insurers made nearly 50 million prior authorization determinations in 2023
An analysis by KFF released Jan. 28 found that Medicare Advantage insurers made nearly 50 million prior authorization determinations in 2023. The finding reflects continued year-over-year increases from 2022 (42 million) and 2021 (37 million) as more people have enrolled in MA. KFF also found that in 2023 there was an average of nearly two prior authorization determinations per MA enrollee.
AHA releases final Health Care Plan Accountability Update for 2024
The AHA Dec. 17 released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and regulation of private health insurers, as well as other resources from the last quarter.
Senate report scrutinizes Medicare Advantage prior authorization denials for post-acute care services
A report released Oct. 17 by the Senate Homeland Security Committee’s investigative subcommittee scrutinizes some of the nation's largest Medicare Advantage insurers for their use of prior authorization and high rates of denials for certain types of care.
GAO report finds lack of oversight on Medicaid managed care plans’ prior authorization requirements for children
A report released May 29 by the Government Accountability Office found a lack of state oversight on Medicaid managed care plans’ use of prio
AHA urges HHS OIG to further scrutinize Medicare Advantage organizations' use of prior authorization for post-acute care
The AHA Sept. 17 urged the Department of Health and Human Services’ Office of Inspector General to further scrutinize policies and practices by certain Medicare Advantage Organizations (MAOs) that impede patient access to post-acute care and circumvent rules designed to ensure access and coverage parity between MA and Traditional Medicare.
Analysis: Medicare Advantage prior authorization requests increase by 9 million in 3 years
More than 46 million prior authorization requests were submitted to Medicare Advantage insurers in 2022, according to KFF analysis released Aug. 6 examining data submitted by MA insurers to the Centers for Medicare & Medicaid Services on prior authorization requests, denials and appeals from 2019 through 2022.
UnitedHealth Group creates gold card program
UnitedHealth Group Aug. 1 announced the creation of a gold card program for qualified practices. Under the program, the practices that earn gold card status will not be required to submit prior authorization requests for certain medical, behavioral and mental health services.
Senate Aging Committee holds hearing on transparency, health care costs
The AHA submitted a statement July 11 for a Senate Special Committee on Aging hearing on health care transparency and lowering health care costs.