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ASCRS and Medical Community Call on CMS To Provide Guidance to MA Plans on the Prior Authorization Process

This week, ASCRS and the medical community sent a letter to the Centers for Medicare and Medicaid Services (CMS) urging the agency to provide guidance to Medicare Advantage (MA) plans on prior authorization (PA) processes through its 2020 Call Letter. Specifically, the letter recommends that CMS provide examples of criteria for selective application of PA requirements based on ordering/prescribing patterns that align with evidence-based guidelines and historically high PA approval rates. This would help address current PA practices that not only increase administrative burden, but more importantly create barriers to accessing timely treatments that jeopardize patient health outcomes. We will keep you updated. 

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