Final MA Rule Solidifies Prior Authorization WinsAPTA The APTA-supported provisions announced by CMS will help reduce administrative burden and ensure consistency across MA plans. In a win for APTA and other organizations fighting to reduce administrative burden, the U.S. Centers for Medicare & Medicaid Services has put up additional guardrails on the use of prior authorization in Medicare Advantage plans. Among the provisions of the 2024 MA final rule: limits on the application of prior authorization, assurances that a prior authorization approval remains valid as long as medically necessary, and accommodations for patients in transition from one MA plan to another. Prior Authorization Versus Preserving Continuity of CareTaken as a whole, the prior authorization-related changes in the final rule are aimed at ensuring MA plans don't apply requirements that disrupt care. According to a CMS fact sheet, the intent is to ensure that MA enrollees receive the same services and items as beneficiaries in the Medicare fee-for-service program. Among the changes: Prior Authorization Approvals to Remain in Effect for as Long as Necessary Limits on Prior Authorization Use |