AHA Tells MedPAC MA Prior Authorization Delays Hospital Discharges
The American Hospital Association sent comments to MedPAC responding to the commission's September preliminary findings on post-acute care use, arguing Medicare Advantage prior authorization is causing discharge-ready patients to remain in acute care beds longer than necessary. MedPAC found MA beneficiaries had far fewer inpatient rehabilitation facility stays than fee-for-service beneficiaries and longer acute care stays before transfer to rehab or long-term care hospitals. AHA's Ashley Thompson wrote that these patterns match hospitals' experiences with MA utilization management delaying discharge and restricting recommended post-acute care levels, including plans steering patients toward skilled nursing facilities instead of recommended settings. AHA urged MedPAC to adjust comparisons for beneficiary characteristics and measure time between discharge readiness and plan authorization decisions, noting plans appear not to be following a 2024 CMS rule requiring faster prior authorization turnaround times.