The Nebraska Legislature passed the Ensuring Transparency in Prior Authorization Act last week which is now headed to Governor Jim Pillen for approval.
Healthcare providers would lose more than $770 billion in revenue over the next decade under the congressional spending bill passed by the U.S House. The spending bill would also increase uncompensated care costs by $278 billion, with hospitals facing the largest increase ($102 billion).
Federal officials are raising questions about exploding drug discounts under a program meant to fund services for low-income patients, and Ohio's Cleveland Clinic is at the center of some of them.
For newly initiated audits of MA plans, CMS will audit all eligible MA contracts for each payment year. Additionally, for audits already initiated, CMS will expedite the completion of audits for payment years 2018 through 2024.
AMA leaders are “eager to meet” and “serve as a resource” on how to address burdensome prior authorization, AMA executive vice president and CEO James L. Madara, MD, told Mehmet C. Oz, MD, the new administrator of the Centers for Medicare & Medicaid Services (CMS), in a recent letter.
The bill contains measures directly responding to high-profile public scrutiny of the insurance industry over the past year on issues including prior authorization and proposed time limits on the use of anesthesia.