Faster Healthcare Access: Medical Decisions by Physicians Only
New rules aim to speed up access to medical care for Medicare beneficiaries. Decisions on medical necessity, including prior authorizations, will be made exclusively by physicians, reducing unnecessary delays. Citizens will gain greater transparency in the healthcare authorization process.
Key points
Prior authorizations and adverse determinations for Medicare services will be made solely by physicians.
Medical necessity criteria must be based on generally accepted medical standards and will be publicly accessible.
Insurance plans will be required to publish statistics on approvals and denials of services, increasing process transparency.
Expired
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