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AAHAM Government Relations Monthly Town Hall Discussions
The AAHAM Government Relations Committee would like to hold monthly calls with Chapter Presidents, Chapter Government Relations Chairs and Members who are interested in becoming active in AAHAM’s legislative healthcare reform initiatives. What happens in Washington usually starts back home in your states. These calls will generate discussions on what is happening in Washington and will enable intel to be shared on what is happening across the country at the state level. These sessions will be focused on healthcare issues that are taking place. These calls will also serve as an opportunity to use this information as a grassroots blueprint to utilize in your own chapter.

The next call is tentatively scheduled for scheduled for Thursday, February 23, 2023, at 4:30 PM EST.  The meeting information will be sent the week before the session.

Subsequent calls in 2023 will be on the 4th Thursday of the month at 4:30 PM EST.

Click here to register for the next call Click here to submit topics for discussion

Thursday, September 15, 2022

CBO Scorring of HR 3173

H.R. 3173 would require most Medicare Advantage plans to establish an electronic program for prior authorizations and to report new data to the Secretary that would later be made publicly available. The new data would include a list of services subject to prior authorization as well as data on several metrics specified in the legislation. For example, plans would be required to report the number of service requests that they received and the share of those requests that were denied.

In addition, plans would be required to respond to expedited requests for prior authorization of services within 24 hours and to other requests within seven days. Most provisions of H.R. 3173 would go into effect three years after enactment, but the data reporting requirements would go into effect four years after enactment. For this estimate, CBO assumes that H.R. 3173 will be enacted before the end of calendar year 2022.

Under current law, prior authorization is a utilization management tool that limits coverage to cases that meet the plan’s standards of review. By placing additional requirements on plans that use prior authorization, we expect H.R. 3173 would result in a greater use of services. We expect Medicare Advantage plans would increase their bids to include the cost of these additional services, which would result in higher payments to plans.
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