In a statement submitted on May 8 for a Senate Budget Committee hearing on reducing administrative burden in health care, the American Hospital Association (AHA) called on Congress to simplify and streamline the prior authorization process in Medicare Advantage. AHA emphasized that these processes not only create financial strain on the health care system but also contribute to provider burnout. Surgeon General Vivek Murthy recently issued an advisory highlighting the negative impact of burdensome documentation requirements, including prior authorization, on health care worker burnout.
AHA recommended several actions for legislators to take in order to address these issues, including making prior authorization requirements more uniform, conducting more frequent audits of Medicare Advantage plans with a history of inappropriate denials, establishing a provider complaint process for violations, enforcing penalties for non-compliance, and clarifying states’ roles in oversight. AHA also called for prompt payment requirements for in-network services provided to enrollees by MA plans and suggested interest penalties for delayed payments.
Additionally, AHA expressed support for legislation that supports gold carding programs and endorsed CMS’s proposed rule to standardize claims attachments under HIPAA. By implementing these changes, AHA believes that the administrative burden in health care can be significantly reduced, leading to a more efficient and effective system for both providers and patients.