Home Health

Bill would automate prior authorization through Medicare Advantage plans

Congress is considering legislation that would automate the prior authorization process within Medicare Advantage plans.

Home health agencies and other providers under Medicare Advantage plans must receive prior authorization before they can visit a patient, which has caused some frustration among agencies.

For example, a patient is being discharged from the hospital to home health and the discharge planner calls the agency and lets the agency know. While the agency may be eager to send a clinician out to conduct a visit the next day, they can’t do so until the Medicare Advantage plan authorizes that visit.

The Improving Seniors’ Timely Access to Care Act would encourage integration of the electronic prior authorization submission into electronic medical record systems.

Related link: Read the bill at http://bit.ly/2ofZMdL.