CMS Launches Prior Authorization Trial For Some Medicare Services
Health care service companies are being asked to join a program that relies on technology to review certain fee-for-service Medicare requests. A program-affiliated medical professional will give the final ruling on a claim. Plus, Social Security Administration payment changes start in July.
Modern Healthcare:
CMMI To Add Prior Authorizations To Some Medicare
The Centers for Medicare and Medicaid Services will test a new model that adds prior authorization requirements to some services for traditional Medicare. The Center for Medicare and Medicaid Innovation unveiled the Wasteful and Inappropriate Service Reduction, or WISeR, demonstration Friday. (Tepper, 6/27)
In other Medicare news —
Modern Healthcare:
Blue Shield Of CA Cuts Some Medicare Advantage Commissions
Blue Shield of California will end commissions for new enrollments in some of its wider network Medicare Advantage plans next week. The nonprofit insurer will cease paying brokers who sign up new members in its preferred provider organization, or PPO, plans in Alameda, Orange and San Diego counties effective July 1, the company wrote in a notice to third-party sellers Thursday. “This was a difficult business decision but one we believe is necessary in the current climate,” the insurer said in the notice. (Tepper, 6/27)
North Carolina Health News:
NC Senate Budget Slashes Senior Insurance Counseling Program
The North Carolina Senate proposed budget released in April would cut state funds for a popular program that helps seniors make better choices for their Medicare plans. For now, the program stands, as state lawmakers are at a standstill on budget negotiations and don’t expect to come to an agreement before the new fiscal year starts on July 1. (Vitaglione, 6/30)
On Social Security payments —
USA Today:
Social Security Change Coming In July: Agency Begins Taking Back 50% Of Overpayments
The Social Security Administration, which overpays billions in benefits annually, will start withholding some benefits sent to overpaid recipients. (Snider, 6/29)
