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Medicare prior authorization expands to ambulatory surgical centers

Medicare beneficiaries in 10 states will soon be participating in a new prior authorization program. The Centers for Medicare & Medicaid Services (CMS) is implementing a five-year demonstration ...
JD Supra

CMS Tests Prior Authorization for Ambulatory Surgery Centers: Preparing for the 2025 Demonstration

CMS is launching a five-year Prior Authorization Demonstration for certain ambulatory surgical center (ASC) services beginning December 15, 2025, in 10 states, including Georgia, Florida, Tennessee, ...
JD Supra

Ambulatory Surgical Centers to Face Heightened Prior Authorization Requirements Under CMS Demonstration Project

Our Health Care Group reviews a new five-year CMS demonstration project requiring ambulatory surgical centers (ASCs) in 10 states to obtain approval before performing certain procedures. The ...

First-of-its-kind study: Analysis finds prior authorization delays elective spine surgery without cutting costs

Researcher found 80% of claim denials were ultimately reversed, reinforcing long-standing concerns raised by AAOS and patient advocates ...
EurekAlert!

Medicare prior authorization affecting plastic and reconstructive surgery didn’t have hoped-for effect

A policy aiming to save Medicare money has not had the intended effect on outpatient surgery. As the policy expands across the country, researching the results of this policy could inform how ...