Transparency

CMS Strengthens Price Transparency for Hospitals - 11/29/2023

A new Centers for Medicare & Medicaid Services final rule aims to strengthen hospital price transparency regulations for 2024, a move physicians hope will address weaknesses in prior policy that hindered them and patients from making informed health care decisions.


Plans Should Inform Patients of Network Status When Requiring PA - 03/25/2019

When a patient is preauthorized to receive a health care service scheduled at a facility, the health plan should use the information submitted on the standardized prior authorization form to inform the patient of the network status of any physicians or health care providers who may be involved in the preauthorized health care. It also should be used to educate the patient on what level of coverage the health plan will provide and what the patient’s financial responsibility will be to all physicians and providers.


Bring Transparency to Prior Authorization - 03/25/2019

Insurance companies need to stop creating hurdles to maintaining the patient-physician relationship. Unquestionably, prior authorization is a significant hurdle. HB 2327 would not eliminate this hurdle altogether for all physicians and patients, but it would make the prior authorization process easier to navigate and make health plans more accountable for the processes they put in place.