‘Care Delayed Is Care Denied’: What Prior Authorization Changes Mean for Home Health Providers

Home health providers could potentially see a speedier prior authorization process thanks to legislation moving through Washington, D.C. While the changes in the Improving Seniors’ Timely Access to Care Act are welcomed, many experts in the space feel like more work needs to be done in order to have a more efficient care delivery process. “In addition to requiring electronic prior authorization, the Improving Seniors’ Timely Access to Care Act requires MA plans to publicly share what their prior authorization rules are,” Alina Czekai, vice president of strategic partnerships at Cohere Health, told Home Health Care News. “It also requires them to share with CMS their approval rates, denial rates and overall just adds more transparency to the system.” Cohere Health is a digital health company focused on transforming prior authorization. Broadly, prior authorization is the process that occurs when a physician is requesting a patient receive a certain service, medication or procedure from a health insurance company.