AMGA Supports Efforts to Streamline Medicare Advantage Prior Authorization
In our letter today, AMGA endorsed a number of proposed improvements to the Medicare Advantage (MA) program, including reforms to prior authorization policies and plan coverage criteria and determinations.
Alexandria, VA – AMGA today endorsed a number of proposed improvements to the Medicare Advantage (MA) program, including reforms to prior authorization policies and plan coverage criteria and determinations. In comments on the Centers for Medicare & Medicaid Services’ proposed updates to the MA program, AMGA emphasized the importance of reducing prior authorization when possible.
“AMGA has long called for reforms to how payers use prior authorization,” said AMGA President and CEO Jerry Penso, MD, MBA. “CMS is moving in the right direction with its proposed changes.”
The CMS proposal also includes reforms to MA plans’ coverage policies and use of utilization management committees. AMGA supports CMS’ proposals to ensure plans adhere to Medicare’s coverage policies and that a medical director leads the new committees. AMGA recommends that CMS expand on its proposal and ensure providers who contract with the plan have an opportunity to provide input to the committee.
The letter is available on AMGA’s website.
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About AMGA
AMGA is a trade association leading the transformation of healthcare in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans. For more information, visit amga.org