The AOA supports reforms to reduce administrative burdens, particularly related to prior authorization (PA), which has increasingly delayed care and burdened physician practices. Recently, the AOA submitted comments to the Centers for Medicare and Medicaid Services (CMS) on the CY2026 Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program and Programs of All-Inclusive Care for the Elderly Proposed Rule.
The comments emphasized the importance of reducing administration burdens, greater transparency and improving network adequacy to ensure patient access to care, especially in underserved areas.
Key recommendations included:
- Requiring publicly accessible, evidence-based criteria for PA decisions
- Enhancing health equity analysis for PA policies to address disparities
- Promoting AI transparency in MA utilization management and limiting automated denial of services
- Strengthening rules to ensure MA plans maintain comprehensive provider networks, and more!
Be sure to read the full comments to learn more about our recommendations to reduce barriers to care and ways to protect the physician-patient relationship to improve care delivery and physician practice sustainability.
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