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Neurosurgeons Applaud Lawmakers for Asking CMS to Review Prior Authorization Practices
Bipartisan letter requests that CMS assess the use of prior authorization in Medicare Advantage

Washington, DC—The American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) applaud and thank the 103 bipartisan members of the U.S. House of Representatives who signed a letter today to Centers for Medicare & Medicaid Services (CMS) Administrator, Seema Verma. The letter, spearheaded by Reps. Phil Roe, MD (R-Tenn.) and Ami Bera, MD (D-Calif.), requests that CMS improve how prior authorization works under Medicare Advantage (MA). Recognizing “that patients may be encountering barriers to timely access to care that are caused by onerous and often unnecessary prior authorization requirements,” the letter urges CMS do the following:

• Issue guidance to Medicare Advantage plans to dissuade the widespread use of prior authorization and to provide direction to the health plans to increase transparency, streamline prior authorization, and minimize the impact on patients;
• Ensure that these requirements do not create inappropriate barriers to care for Medicare patients; and
• Collect data on the scope of prior authorization practices — including denial, delay and approval rates.

“Prior authorization — a tool insurance companies use to limit the medical services they cover — is a cumbersome process that we believe is being inappropriately used by Medicare Advantage plans,” said Ann R. Stroink, MD, FAANS, a practicing neurosurgeon from Bloomington, Illinois, and chair of the AANS/CNS Washington Committee.

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