American Academy of Ophthalmology: Georgia's Medicare Advantage Beneficiaries Get Relief from Abusive Prior Authorization Policy
Retrieved on:
Thursday, August 3, 2023
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SAN FRANCISCO, Aug. 3, 2023 /PRNewswire/ -- The American Academy of Ophthalmology, the American Society of Cataract and Refractive Surgery (ASCRS), and the Georgia Society of Ophthalmology applaud Humana for rolling back its prior authorization requirement for cataract surgery for Medicare Advantage beneficiaries in Georgia. Last year, Humana began requiring pre-approval through iCare Health Solutions for all cataract and posterior capsulotomy (or YAG laser capsulotomy) surgeries. This irrational policy caused unnecessary treatment delays and denials for people in Georgia who needed surgery to restore their sight. Humana's decision is effective August 1.
Key Points:
- One month after Aetna's partial reversal, Humana instituted its own prior authorization policy for cataract surgery patients living in Georgia.
- "We will continue to pressure Aetna to retract its policy for people enrolled in Medicare Advantage in Florida and Georgia."
- The Academy is urging Congress to seize on this momentum and get commonsense prior authorization reforms signed into law this year.
- "Medicare Advantage plans have greatly expanded the use of prior authorization over the years, putting profits over patients.