Medicare Advantage Insurers Face Lawmakers on Prior Authorization, Payment Concerns

Jul 25
Jul 25, 2025

As Medicare Advantage insurers respond to mounting scrutiny over their risk adjustment and prior authorization practices, lawmakers during a recent congressional hearing pressed MA organizations and other stakeholders on ways to address these hot-button topics. The July 22 hearing, “Medicare Advantage: Past Lessons, Present Insights, Future Opportunities,” was held by the Health and Oversight subcommittees of the House Ways and Means Committee.

“I’m particularly excited about the supplemental benefits MA plans provide to improve health and wellness, such as access to fitness memberships, wearable technologies, and healthy meal options,” stated Ways and Means Health Subcommittee Chairman Vern Buchanan (R-Fla.), a longtime supporter of the MA program. Now in its 20th plan year under its current structure, the managed Medicare program is ripe for reform.
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Lauren Flynn Kelly

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.