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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

H.R. 3173, Medicare Prior Authorization

Insurers offering Medicare Advantage plans requiring prior authorization would have to establish an electronic authorization program and meet new standards for decision timing and transparency under a modified version of H.R. 3173.

The Health and Human Services Department would have to approve the electronic authorization programs and would also set time frames and transparency requirements for prior authorization decisions for Medicare Advantage plans.

Medicare Advantage plans allow individuals to obtain coverage normally provided through Part A (hospital) and Part B (medically necessary and preventive services) from approved private insurers.

MA plans, like other insurance plans, often require health care providers to obtain prior authorization for certain medical treatments before they can treat patients. In a September 2018 report, HHS’ Office of Inspector General found that MA plans overturned 75% of their denials for preauthorization — raising concerns that some MA beneficiaries and providers were initially denied services and payments that were medically necessary.
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