Evaluation of Prior Authorization in Medicare Nonemergent Ambulance Transport.

ABSTRACT:

Importance

Some Medicare-reimbursed services are overused or improperly used, resulting in payments for unnecessary services.

Objective

To determine if prior authorization of services vulnerable to improper use is associated with reduced use and costs without changing patient access or health outcomes.

Design setting and participants

This study involved repeated cross-sectional evaluation with a state-level matched control group construction and inverse propensity score weighting at the Medicare beneficiary level. Eight states plus the District of Columbia requiring prior authorization were compared with 13 matched comparison group states not subject to prior authorization. Observations on approximately 1.7 million Medicare beneficiaries spanned January 2012 through D

SUBMITTER: Contreary K 

PROVIDER: S-EPMC9287758 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature