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MA plans and other insurers, AHA wrote, “frequently establish overly stringent medical necessity policies that prevent patients from obtaining necessary care” using the prior authorization process.Īs such, AHA urged CMS to implement greater data-driven oversight of outlier plans “with disproportionately high usage of prior authorization and those with high rates of adverse determinations overturned on appeal” for potential enforcement. Prior authorization decision timelines of seven days for standard requests and 72 hours for urgent cases also weren’t enough for the provider group.Ĭiting care delays and expenses that are particularly unnecessary “as the industry implements technology improvements that enable timely information exchange,” AHA called for a 72-hour deadline for standard, non-urgent requests and a 24-hour turnaround for urgent services.ĪHA wrapped up its comments by highlighting Office of Inspector General data showing that the majority of MA plan prior authorization and claims denials were overturned when appealed. RELATED: MGMA: Large majority of groups surveyed report increase in prior authorization requirements since 2020 This approach would go a long way in reducing unnecessary care delays and clinician burden while giving the plan the ability to ensure care adheres to the patient’s coverage rules.” “The would still be permitted to require a provider to request prior authorization in instances where the provider historically has not met that threshold. “We urge CMS to modify the proposed regulations to require MAOs to automatically consider a service authorized when the provider for that service has a history of prior authorization approval of 90% or greater,” AHA wrote.
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Services that overwhelmingly are approved represent an opportunity to avoid delays and administrative burden, the group wrote. “By excluding, the agency would be withholding these benefits from many Medicare beneficiaries.”ĪHA’s letter went on to “strongly encourage” CMS to set a concrete requirement on when prior authorization should or should not be necessary. “The proposal establishes that impacted plan beneficiaries, including those belonging to managed care plans, would experience improved efficiencies in the manner in which they receive care by reduced timelines and procedural improvements,” AHA wrote. AHA noted in its comments that roughly a third of all Medicare beneficiaries, about 22 million people, are enrolled in a MA plan and that the Congressional Budget Office projects that share to increase to 47% by 2029. In a Tuesday letter to CMS Administrator Chiquita Brooks-LaSure, AHA reiterated its general support for the proposed rule while homing in on some of its initial arguments that the regulation could be doing more to improve outcomes among a greater number of patients.Ĭhief among these critiques was the “extremely troubling” exclusion of MA plans from the proposed requirements. RELATED: Lawmakers aim to move 'very quickly' to pass bill mandating electronic prior authorization for MA plans The former argued that compliance would place an uneven and expensive burden on payers and health IT vendors, while the latter said the rule would stamp delays in treatment and create a more standardized submission process across various plans. The fort serves as a plinth for the 60 metre tall octagonal column that carries the statue of the Madonna della Lettera.The tentative regulation initially drew concerns from payers and applause from providers. The letter ended with the words “Vos et ipsam civitatem benedicimus” The Golden Madonninaġ900 years later the same words were inscribed on the old fort San Salvatore. In the letter to the people of Messina, the Holy Mother said that she appreciated their devotion and would grant them perpetual protection. The letter, which was written in Hebrew, was rolled and tied with a lock of her hair. Here they met with the Mother of Christ and persuaded her to send a letter to the citizens of Messina.
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And some of them insisted on accompanying Paul on a trip to Palestine. The locals were not too eager to give up their old deities, but by and by great numbers were persuaded. Legend has it that the Apostle Paul came to Messina around this time two thousand years ago to convert the Sicilians to Christianity. It is a quote from a letter the Virgin Mary sent to the population of Messina in the year 42.
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The answer is provided by Google, who tells me that the meaning of the inscription is “We bless you and your city”. The statue greeting all visitors who enter Messina from the sea.