The American Hospital Association Calls for Simplifying Prior Authorization Requirements in Medicare Advantage to Ease Healthcare Workforce Burden

The American Hospital Association (AHA) has called on Congress to streamline the prior authorization process in Medicare Advantage, stating that current practices add financial burden and strain to the health care system. In a statement submitted on May 8 for a Senate Budget Committee hearing, the organization emphasized that these requirements are a major burden to the health care workforce and contribute to provider burnout.

Surgeon General Vivek Murthy recently issued an advisory noting that burdensome documentation requirements, including prior authorization, are contributing factors to health care worker burnout. AHA urged legislators to simplify and standardize prior authorization requirements, conduct more audits on plans with a history of inappropriate denials, establish a provider complaint process for suspected federal violations, enforce penalties for non-compliance, and clarify state oversight roles in Medicare Advantage.

In addition to these recommendations, AHA also expressed support for legislation promoting gold carding programs and endorsed CMS’s proposed rule to standardize claims attachments under HIPAA. By implementing these measures, AHA believes the administrative burden in health care can be reduced and the system can operate more efficiently.