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Managed Medicaid: Ensuring Quality Health Care Delivery
Data-driven strategies to combat Medicaid managed care organization (MCO) denials and ensure quality health care delivery for Medicaid enrollees.
Study finds 90% of Medicaid managed care plans cover at least one AUD medication without priority and quantity limits
A JAMA Network Open study published March 13 found that 90% of Medicaid managed care plans cover at least one alcohol use disorder medication without prior authorization and quantity limits.
Report highlights how health care can avoid $20 billion in spending
The Council for Affordable Quality Healthcare Feb. 11 released a report highlighting how the health care industry can save $20 billion by transitioning from manual to electronic workflows.
The Impact of the New Prior Authorization Rule
In this conversation, Andrea Preisler, Jennifer Cameron, and David Jacobson, M.D., discuss what the new prior authorization rule means for making sure clinicians can do what they do best: taking care of their patients.
KFF: MA insurers made nearly 50 million prior authorization determinations in 2023
An analysis by KFF released Jan. 28 found that Medicare Advantage insurers made nearly 50 million prior authorization determinations in 2023. The finding reflects continued year-over-year increases from 2022 (42 million) and 2021 (37 million) as more people have enrolled in MA. KFF also found that in 2023 there was an average of nearly two prior authorization determinations per MA enrollee.
AHA releases final Health Care Plan Accountability Update for 2024
The AHA Dec. 17 released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and regulation of private health insurers, as well as other resources from the last quarter.
AHA Support of House Improving Seniors' Timely Access to Care Act
The AHA expresses support for the Improving Seniors’ Timely Access to Care Act.
Senate report scrutinizes Medicare Advantage prior authorization denials for post-acute care services
A report released Oct. 17 by the Senate Homeland Security Committee’s investigative subcommittee scrutinizes some of the nation's largest Medicare Advantage insurers for their use of prior authorization and high rates of denials for certain types of care.
GAO report finds lack of oversight on Medicaid managed care plans’ prior authorization requirements for children
A report released May 29 by the Government Accountability Office found a lack of state oversight on Medicaid managed care plans’ use of prio
Webinar: Overview of the Advancing Interoperability and Improving Prior Authorization Processes Final Rule
Overview of the Advancing Interoperability and Improving Prior Authorization Processes Final Rule webinar and powerpoint.