A bill to reform prior authorization requirements for Medicare Advantage (MA) – a massive burden that nursing home operators have been trying to change for some time – was reintroduced on Capitol Hill Thursday. Nursing homes have long argued that this aspect of MA needs to be right-sized through legislation. The Reducing Medically Unnecessary Delays […]
American Medical Association
Last week’s finalized 2.83% cut to the Physician Fee Schedule (PFS), which follows a series of payment reductions of recent years for rehab and therapy services for Medicare beneficiaries, is raising concerns about tightening access to such care in nursing homes, with physicians calling the situation unsustainable. For physicians, this particular cut in the PFS […]
While prior authorization has a legitimate role in Medicare Advantage coverage, the practice has expanded to the point of negatively affecting care. This aspect of MA needs to be right sized, and likely through legislation, nursing home leaders said. About 90%-plus of physicians, including those serving nursing home patients, have said that one or more […]
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