News and Publications

Representatives urge pause to prior auth requirements

May 18, 2020

Members of the House Committee on Small Business, Nydia M. Velazquez (D-NY-07), Sharice L. Davids (D-KS-03), Dwight Evans (D-PA-03), Jason Crow (D-CO-06), and Abby Finkenauer (D-IA-01), have sent a letter to the Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma urging CMS to waive certain  prior authorization requirements for the duration of the current national emergency. The representatives cite CMS recommendations forcing physician practices to postpone elective surgeries and limiting of non-urgent care. These changes leave critical care as the only remaining procedures. In this extraordinary circumstance, they argue that those patients should not be burdened with delays cause by prior authorization requirements. Additionally, the representatives reference stories from America’s physicians detailing furloughs and layoffs of administrative staff which in turn leaves the physicians themselves to manage care and billing. They argue that physicians should be focused solely on providing critical care and not be limited by unnecessary delays or time spent devoted solely to billing.