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Regulatory Advisory: Health Data, Technology and Interoperability (HTI-4) FY 2026 Final Rule

The Centers for Medicare & Medicaid Services (CMS) July 31 issued its hospital inpatient prospective payment system (PPS) and long-term care hospital (LTCH) PPS final rule for fiscal year (FY) 2026.
Public

AHA Comments on the CMS and ASTP/ONC Request for Information Re: The Health Technology Ecosystem

AHA comments on the Centers for Medicare & Medicaid Services and Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology Request for Information regarding the Health Technology Ecosystem.

CMS announces new prior authorization program pilot

The Centers for Medicare & Medicaid Services June 27 announced the rollout of a 6-year technology-enabled prior authorization program pilot.

HHS announces initiative with insurers to streamline prior authorizations 

The Department of Health and Human Services June 23 announced an initiative coordinated with multiple health insurance companies to streamline prior authorization processes for patients covered by Medicare Advantage, Medicaid managed care plans, Health Insurance Marketplace plans and commercial plans.

GAO says CMS should target behavioral health services in prior authorization audits

The Government Accountability Office May 29 released a report recommending the Centers for Medicare & Medicaid Services target behavioral health services when auditing Medicare Advantage plans’ use of prior authorization.
Public

AHA Senate Letter Supporting Improving Seniors’ Timely Access to Care Act

AHA expresses support for Senate legislation, the Improving Seniors’ Timely Access to Care Act.
Public

AHA House Letter Supporting Improving Seniors’ Timely Access to Care Act

AHA expresses support House legislation, the Improving Seniors’ Timely Access to Care Act.

Managed Medicaid: Ensuring Quality Health Care Delivery

Data-driven strategies to combat Medicaid managed care organization (MCO) denials and ensure quality health care delivery for Medicaid enrollees.

Study finds 90% of Medicaid managed care plans cover at least one AUD medication without priority and quantity limits

A JAMA Network Open study published March 13 found that 90% of Medicaid managed care plans cover at least one alcohol use disorder medication without prior authorization and quantity limits.

Report highlights how health care can avoid $20 billion in spending

The Council for Affordable Quality Healthcare Feb. 11 released a report highlighting how the health care industry can save $20 billion by transitioning from manual to electronic workflows.