RRC leads efforts to improve patient access to care through proper regulation of prior authorization and reduction of administrative burdens.
Regulatory Actions
CMS' Contract Year 2026 Medicare Advantage Proposed Rule
RRC provided comments on CMS' Contract Year 2026 Medicare Advantage Proposed Rule, which included several provisions of interest to RRC, including prior authorization, provider directories, MA plans' internal coverage criteria policies, and the Medicare Loss Ratio.
Read RRC's Comment LetterCMS' Request for Information on Medicare Advantage Data
RRC responded to CMS' Request for Information about additional data collection that may be useful with respect to the MA program. In the comments RRC emphasized that additional data collection from MA plans can provide additional insight into the impact of prior authorization.
Read RRC's Comment LetterCMS' Prior Authorization Demonstration for Ambulatory Surgical Center Services
CMS' Prior Authorization Demonstration for Ambulatory Surgical Center Services would require Ambulatory Surgical Centers to obtain prior authorization before providing certain surgical procedures. RRC provided several questions to CMS about this demonstration and expressed concerns regarding the proposed information collection activity.