From the HHS Office of Inspector General raising concerns over denial rates to Health Care Service Corporation expanding its use of AI technology, here are four updates on prior authorization reported by Becker's since July 13:
1. Molina Healthcare had the highest overall prior authorization denial rate in 2019 among the seven largest Medicaid managed care organizations, according to an audit from HHS' Office of Inspector General.
2. HHS' Office of Inspector General raised concerns about the rate of prior authorization denials in Medicaid managed care overall and a lack of state oversight of these denials.
3. A California bill aiming to reform the prior authorization process has advanced out of the Assembly health committee.
4. Health Care Service Corporation, which operates Blue Cross Blue Shield affiliates in Illinois, Texas, Oklahoma, Montana and New Mexico, is expanding its use of AI technology to make the prior authorization process up to 1,400 times faster.