Medicare Advantage: CMS Oversight Of Prior Authorization Criteria Should Target Behavioral Health Services

On May 22, 2025, the U.S. Government Accountability Office published this report that found that oversight of prior authorization criteria by the Centers for Medicare & Medicaid Services (CMS) should target behavioral health services. CMS oversight of prior authorization criteria currently does not target these services in its audits to determine any effects on enrollees' access to care . . .