MGMA Washington Connection 03/31/2022

03/31/2022 9:05 AM | Rebekah Francis (Administrator)

MGMA submits comments on prior authorization automation

Last week, MGMA submitted comments to the Office of the National Coordinator (ONC) on electronic prior authorization (ePA).  Within the comments, MGMA outlines key recommendations and considerations including its primary goal of reducing the number and frequency of PA, noting that without addressing broader PA, automation could simply increase PA.

While reiterating support for ONC's goal to advance ePA, MGMA also encourages ONC, as well as the Centers for Medicare & Medicaid Services (CMS), to identify and consider other areas of reform. MGMA believes that the burden associated with PA could be reduced through automation, but only if implemented appropriately. Proper implementation includes robust piloting and testing, as well as ensuring an appropriate timeline for implementation. It also includes ensuring there are adequate guardrails in place.

PA requirements continue to increase year after year. To get involved in #MGMAAdvocacy on the matter, send a template letter to Congress advocating for commonsense PA reforms in the Medicare Advantage program!

President Biden releases FY 2023 budget request

On Monday, President Biden released his $5.8 trillion budget proposal for fiscal year (FY) 2023, which included several healthcare related policies that would support the temporary expansion of telehealth, bolster access to behavioral health, and make investments for future pandemic preparedness. The FY 2023 budget also includes a proposal to cut the nation’s deficit by $1.3 trillion from last year.

Presidential budgets do not have the force of law and are intended to serve as statements of administrative priorities, while Congress negotiates the budget. MGMA will continue to advocate on behalf of our members throughout the budget negotiation process.

MGMA to CMS: Improving health equity within value-based care

Yesterday, MGMA submitted comments to the Centers for Medicare and Medicaid Services (CMS) providing feedback to the agency on how to support practices in value-based care arrangements and improve health equity. CMS recently hosted a roundtable discussion with leaders across the healthcare industry to identify how CMS can support safety net providers participating in payment models.

Within the comments, MGMA recommended CMS expand the definition of safety net to include small and rural practices, as they similarly provide critical care to sicker, poorer, and disadvantaged patient populations. Extending support within value-based care to these practice types will help CMS achieve their goal to improve health equity within the healthcare system.

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