On MA prior auth, Congress proposes relief — but CMS is ahead of the game

A couple of new bills — or rather, retreads of old bills — demonstrate increased congressional interest in reforming prior authorization (PA) under Medicare Advantage (MA). While the success of these bills is not assured, a recent proposed rule shows CMS is willing to move on this issue itself, with Congress serving more as a cheerleader than as a legal authority.

Cohere Health’s Alina M. Czekai, Vice President of Value-Based Care Strategy & former Senior Advisor to CMS Administrator Seema Verma, who worked on the original rule, sat down with Roy Edroso, Editor, Part B News, to discuss how the legislation would improve transparency within the prior authorization process, reduce physician burden, and result in faster access to patient care.

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