Medicare Advantage
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…
The AHA applauds the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) for your recently announced review of Medicare Advantage Organizations' Use of Prior Authorization for Post-Acute Care.
The Centers for Medicare & Medicaid services Sept.
Hospitals and health systems are seeing significant increases in administrative costs, including due to burdensome practices by commercial insurers that often delay and deny care for patients, according to a new report released Sept. 10 by the AHA.
The Centers for Medicare & Medicaid Services (CMS) has published a new complaint form with instructions for Medicare providers seeking assistance from the agency in resolving Medicare Advantage (MA) claims issues.
Congressional action is needed to ensure greater oversight of MA plans as these rules are implemented and to enable CMS to enforce existing regulations designed to protect beneficiary access to medically necessary services.
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…
The AHA July 11 released its quarterly Health Care Plan Accountability Update, a roundup of news, letters, statements and other resources covering private insurance plans, Medicare Advantage and related issues.
The AHA submitted a statement July 11 for a Senate Special Committee on Aging hearing on health care transparency and lowering health care costs.
The Healthcare Equality Network July 3 sent a letter to the Centers for Medicare & Medicaid Services, expressing concerns about claims denials by commercial insurance companies.