The House Ways and Means Subcommittees on Health and Oversight recently held a joint hearing titled “Medicare Advantage: Past Lessons, Present Insights, Future Opportunities.” The session focused on evaluating challenges, lessons learned, and opportunities to improve the Medicare Advantage (MA) program.
SDAHO Member Dr. David Basel Testifies
David A. Basel, MD, Vice President of Clinical Quality and Population Health Officer at Avera Health and a member of SDAHO, was one of only five individuals invited to testify before the committee, providing insight from both the payer and the provider perspective. Baselās testimony focused on Medicare Advantage in rural areas and the need for consistency, stability and transparency in the program. Specific issues highlighted included administrative burdens such as a high volume of denials, post-acute authorization delays, partial denials for Critical Access Hospital stays, and nonpayment for hospital readmissions. The Committee was highly engaged and the hearing lasted close to four hours.
To read Dr. David Baselās written testimony, click here.
In aĀ statement shared with the subcommittees, the American Hospital Association (AHA) made recommendations to improve prior authorization and other processes for MA. The AHA urged legislators to establish controls for prior authorization usage by MA plans and streamline prior authorization processes for post-acute providers. Additionally, the AHA urged the subcommittees to increase oversight and enforcement of existing prior authorization rules by conducting more frequent and targeted MA plan audits, enforce penalties for noncompliance, provide clarity on statesā role in MA oversight and ensure parity of benefits between MA and Traditional Medicare.
To view AHA Statement on House Ways and Means Committee Hearing on Medicare Advantage, click here.
To view the U.S Ways & Means Joint Health and Oversight Subcommittee Hearing on Medicare Advantage: Past Lessons, Present Insights, Future Opportunities, Click here.
