CMS urges Medicare Advantage plans to relax some prior authorization requirements

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CMS is encouraging all Medicare Advantage organizations and Medicare-Medicaid plans to waive or relax certain prior authorization requirements amid the COVID-19 surge.

In an Aug. 20 letter, CMS asked these health plans to relax the requirements to facilitate the transfer of patients from acute-care hospitals to post-acute and other clinically appropriate settings. 

"The ability of hospitals to transfer patients to appropriate levels of care without unnecessary delays or administrative burdens is critical to ensuring that hospitals have open acute-care beds to treat patients requiring emergent care," CMS said in the letter. 

CMS reminded Medicare Advantage organizations that they can waive these requirements at any time, even absent a disaster or public health emergency.

 

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