GAO Pushes For More Prior Authorization
Don’t count on Medicare seeing the error of its ways when it comes to preauthorization such as the Review Choice Demonstration. The Centers for Medicare & Medicaid Services is getting plenty of pressure from the outside to continue and even expand such programs. For example: In a new report on “priority open recommendations,” the Government Accountability Office urges CMS to “take steps, based on results from evaluations, to continue prior authorization. These steps could include: (1) resuming the paused home health services demonstration; (2) extending current demonstrations; or, (3) identifying new opportunities for expanding prior authorization to additional items and services with high unnecessary utilization and high improper payment rates. The 35-page GAO report is at www.gao.gov/assets/700/698322.pdf.
