AMA House of Delegates Calls on Medicare Advantage to Align Prior Authorization Policies with Medicare Fee-for-Service The American Medical Association (AMA) House of Delegates issued a statement saying that Medicare Advantage plans shouldn’t override physician judgment. According to a resolution presented at the AMA Special Meeting, more than 62 million Americans are covered by...
AMA House of Delegates Addresses Several Issues in June 2021 House of Delegates Annual Meeting Nearly 700 physicians, residents and medical students gathered for the June 2021 American Medical Association (AMA) Special Meeting of the AMA House of Delegates (HOD) held Friday, June 11, through Wednesday, June 16, to consider a wide array of proposals to help fulfill the...
CMS Responds to Request for Delay of Prior Authorization of Cervical Fusion Procedures In a letter dated June 3, 2021, CMS’ Director of Provider Compliance, Connie Leonard responded to an April 7, 2021, letter from a coalition of healthcare stakeholders, including ISASS, asking CMS to delay implementation of prior authorization in the ambulatory surgical center...
Medicare Administrative Contractors Announce Resumption of Payment Reviews Beginning in August 2020 Beginning August 2020, Medicare Administrative Contractors (MACs) resumed post-payment reviews of items and services with dates of service before March 2020. MACs may now begin conducting post-payment medical reviews for later dates of service. The CMS Targeted Probe and Educate program (intensive...