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Share this article WASHINGTON, May 20, 2021 /PRNewswire/ -- In a new May 18, 2021 MGMA Stat poll, 81% of medical group practices reported that prior authorization (PA) requirements have increased since 2020. Only 2% of respondents stated that PA requirements have decreased. "Despite a modest reprieve from certain health plan prior authorization requirements during the first few months of the pandemic, medical groups report a significant spike in prior authorization requirements since 2020," said Anders Gilberg, MGMA SVP of Government Affairs. "In addition to the sharp rise in prior auth...
's "After the Pandemic" series, we asked our editorial board members to discuss what significant and lasting effects the COVID-19 pandemic will have on medicine and the delivery of healthcare. Here, we interview Anders Gilberg, senior vice president for government affairs at the Medical Group Management Association (MGMA) in Washington, D.C. What effects will the pandemic have -- in the aftermath -- on the way medical practices are run? Gilberg: Last year, medical practices were forced to overcome numerous challenges to cope with plunging patient volumes and increased costs while trying...
email article WASHINGTON -- Healthcare groups are applauding efforts being made in Congress to stop two different cuts to the Medicare budget -- both of which are due to "sequestration" requirements -- before it's too late. One cut, part of the normal budget process, is a 2% -- or $18 billion -- cut in the projected Medicare budget under a process known as "sequestration." Sequestration allows for prespecified cuts in projected agency budget increases if Congress can't agree on their own cuts. Medicare's budget had been slated for a 2% sequester cut in fiscal year 2020; howeve...
Cigna eliminates prior authorization for coronary CT scans Getty Images Cigna will no longer require prior authorization for some CT scans of the heart, a move that providers said will relieve administrative burdens among physicians and result in better outcomes for patients. On Feb. 1, Cigna will end prior authorizations for CT angiogram of the heart, coronary arteries and bypass grafts with contrast material. This includes 3D image post-processing. Cigna also removed prior consent for fractional flow reserve-computed tomography. Patients must have stable chest pain and an intermediate risk...