The Centers for Medicare & Medicaid Services (CMS) is proposing new limits on Medicare Advantage (MA) plans regarding prior authorization, utilization management, coverage decisions and the use of artificial intelligence (AI). These proposed changes aim to address the barriers to accessing care identified by CMS. Data reported to CMS by MA plans show that, on […]
Point32Health
Yet another payer organization is removing certain prior authorization requirements for home health care services. Point32Health – the parent company of Harvard Pilgrim Health Care and Tufts Health Plan – announced Wednesday that it is removing prior authorization requirements for the first 30 days of home health care beginning on April 12. The changes will […]