ISMA has joined the AMA and 95 other AMA member organizations in signing a letter to Seema Verma, administrator of the Centers for Medicare and Medicaid Services (CMS), asking CMS to include language about prior authorization (PA) in its 2020 Call Letter to Medicare Advantage plans. 

The AMA’s letter, dated Feb. 28, asks CMS to advise plans that they must carefully consider the care delays associated with PA and the resulting impact on beneficiaries and their health and should target PA requirements where they are most needed. “The guidance should 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,” the AMA’s letter says.

See the AMA’s letter to CMS >>