Comment Letter

Neurosurgery Urges CMS to Improve Prior Authorization in Medicare Advantage

  • Reimbursement and Practice Management

The Honorable Chiquita Brooks-LaSure
Centers for Medicare & Medicaid Services
Department of Health and Human Services
Attention: CMS-1751-P
Mail Stop C4-26-05
7500 Security Boulevard
Baltimore, MD 21244-1850

Re: [CMS–4203–NC] RIN 0938–AV01 Medicare Program; Request for Information on Medicare Advantage (MA RFI)

Dear Administrator Brooks-LaSure:

The Regulatory Relief Coalition (RRC) appreciates the opportunity to comment on the MA RFI referenced above. The RRC is a group of national physician specialty organizations advocating for regulatory burden reduction in Medicare so that physicians can spend more time treating patients. We aim to ensure that prior authorization (PA) is not a barrier to timely access to care for the patients our members serve.

The RRC is pleased that the MA RFI seeks feedback on MA plans’ use of PA. The RFI solicits public comments on how MA plans use utilization management techniques, such as PA; the approaches used by MA plans to exempt certain clinicians or items and services from PA requirements; and the steps CMS could take to ensure utilization management does not adversely affect enrollees’ access to medically necessary care, and each of these areas is addressed below.

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