Members of Congress are taking action to push CMS and the Department of Health and Human Services to reform prior authorization rules as several well-known medical organizations, including the American Academy of Ophthalmology, have warned of safety impacts to patients caused by delays.
Several policies, specifically those imposed by Medicare Advantage plans, have been delaying cataract surgeries, according to a June 21 email sent to Becker's.
Aetna eventually decided to roll back a mandate for prior authorizations for all cataract surgeries a year after it was implemented nationally. However, the policy remains in effect in Georgia and Florida.
Humana has also introduced a prior authorization policy for cataract surgeries in Georgia, sparking industry fears of a nationwide policy expansion.