Changes In Prior Approval Coming To Traditional Medicare, Medicare Advantage

Changes In Prior Approval Coming To Traditional Medicare, Medicare Advantage

There were two major announcements recently regarding prior approval of treatments and services for Medicare beneficiaries.

CMS trials prior authorization for select Medicare services

With all the news about the budget bill, a June 27 press release from the Centers for Medicare and Medicaid Services may have slipped under your radar. The agency touts a new Center for Medicare and Medicaid Innovation pilot program that imposes a prior authorization requirement on several procedures they say will “protect Medicare beneficiaries, federal taxpayers from unnecessary services, fraud, waste and abuse.”  The program, Wasteful and Ina…