A new Biden administration rule released Wednesday aims to streamline the prior authorization process used by insurers to approve medical procedures and treatments.

Prior authorization is a common tool used by insurers but much maligned by doctors and patients, who say it’s often used to deny doctor-recommended care.

Under the final rule from the Centers for Medicare and Medicaid Services, health insurers participating in Medicare Advantage, Medicaid or the ObamaCare exchanges will need to respond to expedited prior authorization requests within 72 hours, and standard requests within seven calendar days.

The rule requires all impacted payers to include a specific reason for denying a prior authorization request. They will also be required to publicly report prior authorization metrics.

  • breadsmasher@lemmy.world
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    11 months ago

    the madness that is US “healthcare” never ceases to amaze me.

    Know what happens when a doctor recommends me a treatment? I get that treatment.

    I don’t have to hope an insurance company will “approve” of me getting that treatment. I don’t have to worry about paying for it.

    Anyone still defending this system needs psychological help. Which would be denied by the insurance company. And cost 10000s out of pocket