AAPM&R Supports Streamlining Prior Authorization

Members & Publications

June 10, 2019

On June 5, the Improving Seniors’ Timely Access to Care Act of 2019 (H.R. 3107) was introduced. This bipartisan bill would improve delivery of care by streamlining and standardizing prior authorization in Medicare Advantage. The bill aims to improve prior authorization by improving transparency, adopting electronic communication systems, and analyzing the products and services subject to prior authorization annually. While this bill was being drafted, AAPM&R's Health Policy and Legislation (HP&L) Committee spoke with Congressional offices during their DC Hill Day asking them to support it upon it’s introduction. 

For a press release on H.R. 3107, please click here.

HP&L has been working tirelessly in 2019 to reduce the burden on our physicians associated with the prior authorization process. HP&L has submitted multiple letters to CMS and has had at least 3 meetings with staff from the Centers for Medicare & Medicaid Services (CMS). One with the Office of the Inspector General (OIG) and one with the Office of Management and Budget (OMB) on prior authorization and reducing physician burden. HP&L plans to submit comments to CMS’ recent Request for Information on reducing administrative burden, guide the Leadership Forum’s advocacy efforts during their July DC Hill Day, and continue advocating for this bill.

 

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.