From UnitedHealthcare starting its second wave of cuts to lawmakers urging CMS to increase its oversight of artificial intelligence used in Medicare Advantage prior authorizations, here are seven updates on prior authorization Becker's has reported since Sept. 18.
1. CMS is proposing new health equity changes for prior authorization policies and procedures at Medicare Advantage organizations to better determine any disproportionate impact on underserved populations that may delay or deny access to services.
2. A group of lawmakers is asking CMS to increase its oversight of artificial intelligence used in Medicare Advantage prior authorization.
3. Blue Cross Blue Shield of Massachusetts is removing 14,000 prior authorization requirements for home care services for its 2.6 million commercial members beginning Jan. 1.
4. The second and final wave of UnitedHealthcare's prior authorization cuts began Nov. 1.
5. The Better Medicare Alliance is recommending a set of policies to Congress and CMS to improve prior authorization, behavioral health access, equity and more in the program.
6. Blue Cross Blue Shield of Michigan intends to cut 20 percent of its prior authorization requirements. James Grant, MD, the payer's senior vice president and chief medical officer, told Becker's the changes are part of an evolving process.
7. UnitedHealthcare and Cigna's prior authorization cuts are steps in the right direction, but the American Medical Association is "careful not to confuse positive developments with major progress," the organization's immediate past president Jack Resneck, MD, said.