The Centers for Medicare & Medicaid Services (CMS) recently announced a new program to test prior authorization requirements for certain services in six states starting Jan. 1.
The states — New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington — will apply prior authorization evaluations to more than a dozen services.
CMS says the pilot program is intended to root out “fraud, waste, and abuse,” but as Medicare Advantage members know well, prior authorization can lead to frustrating delays in care. ARTICLE