House subcommittees hold joint hearing on status of MA
The House Ways and Means Subcommittees on Health and Oversight held a today to discuss lessons learned, challenges and opportunities to improve the Medicare Advantage program. In a shared with the subcommittees, the AHA made recommendations to improve prior authorization and other processes for MA. The AHA urged legislators to establish controls for prior authorization usage by MA plans and streamline prior authorization processes for post-acute providers. Additionally, the AHA urged the subcommittees to increase oversight and enforcement of existing prior authorization rules by conducting more frequent and targeted MA plan audits, enforce penalties for noncompliance, provide clarity on states’ role in MA oversight and ensure parity of benefits between MA and Traditional Medicare.
The AHA also called for greater efficiency and improved access to care through other MA improvements, such as adding prompt payment requirements for MA plans, increasing network adequacy for post-acute care providers, ensuring critical access hospitals receive cost-based reimbursement for MA patients, stopping inappropriate downcoding and requiring transparency in MA plan denial signatures.