{"id":1466,"date":"2025-08-13T13:58:08","date_gmt":"2025-08-13T13:58:08","guid":{"rendered":"https:\/\/emmeacne.com\/?p=1466"},"modified":"2025-08-13T13:58:09","modified_gmt":"2025-08-13T13:58:09","slug":"the-hhs-pilot-program-has-sparked-democratic-concerns-over-medicare-red-tape-sacdepspa-838","status":"publish","type":"post","link":"https:\/\/emmeacne.com\/?p=1466","title":{"rendered":"The HHS pilot program has sparked Democratic concerns over Medicare red tape. SacDepSpa 838"},"content":{"rendered":"\n

House Democrats are demanding more information about a new demonstration by the Department of Health and Human Services (HHS) that they believe will increase red tape by adding prior authorization requirements in Medicare. The Democrats, led by Reps. Suzan DelBene and Ami Bera, question why HHS would want to test adding prior authorization requirements in traditional Medicare when the Trump administration is touting efforts to reduce the practice in Medicare Advantage (MA). The HHS has recently acknowledged the harm of prior authorization, but the Trump administration has not. The CMS has proposed a pilot program to test a model targeting “wasteful, inappropriate services in Original Medicare,” partnering with private companies, including some Medicare Advantage plans that are under fire for using prior authorization to deny a clinician’s request to provide care. The model will require prior authorization for a list of outpatient procedures that the agency has flagged as vulnerable to fraud, waste, abuse, or inappropriate use. The lawmakers are concerned about creating perverse incentives that reward companies that deny the most care.<\/p>\n\n\n\n

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