ASCP is supporting legislation to change the how Medicare governs prior authorization requirements. The bill, H.R. 3173, would impose new requirements relating to prior authorization processes for Medicare Advantage (MA) plans.
If enacted, MA plans would be required to (1) establish an electronic prior authorization program that has the ability to provide real-time decisions; (2) annually publish specified prior authorization information, such as the percentage of requests approved and the average response time; and (3) meet specified standards relating to the quality and timeliness of prior authorization determinations. So far, 151 members of Congress have co-sponsored the bill.
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