Dennis Fliegelman, principal consultant at West Lake Village, Calif.-based ARA Financial Services and former hospital administrator, joined Becker's to discuss how CMS performed in 2022.
Editor's note: This response was edited lightly for clarity and brevity.
Question: How would you grade (A-F) CMS' performance in 2022?
Dennis Fliegelman: As to CMS, they play politics, so a 'C' is all they can garner, e.g. rate change. The authorization delays and denials have been a growing concern that just recently came to the forefront, yet CMS keeps pushing Medicare Advantage plans run by the same commercial payers that are earning record profits by denying legitimate authorizations and care. I also question CMS' methodology to determine what procedures get approval for outpatient reimbursement.