Important Issues

Despite leading the charge locally on reforming prior authorization, MSDC is still working nationally to reform the onerous practice.

On February 13, MSDC and over a hundred other organizations sent a letter to CMS Administrator Chiquita Brooks-LaSure applauding the agency for recent proposed rules on prior auth in Parts C and D. The rules reflect a recent Office of the Inspector General 2022 report showing that 13% of prior auth request denied by Medicare Advantage plans met Medicare coverage rules, and 18% of payment request denials met Medicare and MA billing rules.

The letter ends by urging CMS to finalize the regulations with the recommended changes for MA and Plan D plans.

You can see the whole letter here.