The Medical Group Management Association, a network of over 60,000 medical group leaders, submitted a Feb. 10 letter to CMS weighing in on several key issues for 2023, including prior authorization reform and prescription drug prices.
Here are some of MGMA's key requests:
1. Finalize previously proposed prior authorization rules to lessen medical provider burdens.
2. Apply clinical validity and transparency coverage criteria policies to include prescription drug costs.
3. Establish oversight to hold plans accountable for noncompliance.
4. Include additional prior authorization reforms in future lawmaking.
5. Ensure Medicare and Medicaid both have access to the same items and services.
6. Finalize prior authorization rules allowing patients guaranteed continuity of care.
7. Reinstate the step therapy prohibition in Medicare Advantage plans for Part B medications.
8. Develop gold-carding programs with stakeholders for Medicare Advantage plans.
9. Waive prior authorization requirements for providers in value-based care models.