Easier Access to Care for Seniors in Medicare Advantage Plans
New rules aim to streamline the prior authorization process in Medicare Advantage plans. This means faster decisions, electronic requests, and greater transparency, which should make it easier for seniors to access necessary medical services and reduce bureaucracy.
Key points
Implementation of an electronic prior authorization system to speed up the approval process for medical services.
Requirement for real-time decisions on commonly approved services, with exceptions for urgent situations.
Increased transparency: Medicare Advantage plans must publish data on prior authorizations, including approval and denial rates.
Establishment of enrollee protection standards, including the possibility of waiving prior authorization for providers with good compliance records.
Expired
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