Committee approves amendment to clarify medical-necessity standards and moves SB 1753 to the calendar Committee amended and advanced SB 1753 to recognize certain specialties, align medical-necessity determinations with accepted clinical criteria and place such determinations under licensing-board oversight; vote was unanimous in committee.

Tennessee takes a major step in healthcare reform with the approval of SB 1753, setting new standards for medical necessity that could reshape patient care.

Learn more here!

#TN #CitizenPortal #LicensingAccountability #TennesseeMedical #HealthcarePolicy #MedicalNecessity

A Pregnant Woman at Risk of Heart Failure Couldn’t Get Urgent Treatment. She Died Waiting for an Abortion. In a state that had legislated its commitment to life, Graham spent her final days struggling to find anyone to save hers.

#WomanDies #WomensHealthCare #Choice #Abortion #HeartFailure #MedicalNecessity #CijiGraham #NorthCarolina

ProPublica:

www.propublica.org/article/nort...

The Role of the Insurance Company in Prior Authorization Decisions

staffingly.com/the-role-of-...

#PriorAuthorization, #HealthInsurance, #HealthcareAdministration, #MedicalNecessity, #RevenueCycleManagement

Massachusetts lawmakers introduce bill on artificial intelligence in healthcare decision-making Senate bill mandates AI compliance with medical necessity standards in healthcare utilization review

Massachusetts lawmakers are pushing a groundbreaking Senate bill that ensures AI systems meet essential medical necessity standards in healthcare decisions.

Learn more here!

#MA #CitizenPortal #AIEthics #HealthcareReform #MedicalNecessity

Medicaid to Align Prosthetic Device Reimbursement with Federal Medicare Rates Medicaid will reimburse custom devices at Medicare's rates following medical necessity documentation.

Big news for Pennsylvanians: Medicaid will now reimburse custom prosthetic devices at Medicare's rates, but only with the right documentation!

Get the details

#PA #MedicalNecessity #CitizenPortal #PennsylvaniaMedicaid #HealthcareAccess #ProstheticReimbursement

7/8
Smith's comparison to smoking & driving ignores a critical difference—this isn't about restricting activities but denying healthcare recognized by medical professionals as necessary treatment for a diagnosed condition.

The harm isn't theoretical but immediate.
#MedicalNecessity #YouthRights

Health Insurers Limit Coverage of Prosthetic Limbs, Questioning Their Medical Necessity - KFF Health News Advocates say it is discrimination and are arguing for “insurance fairness” on the grounds that people who have joints surgically replaced typically don’t face the same kinds of coverage challenges.

Defining #MedicalNecessity for #ProstheticLimbs has long been challenging, though has become even more of an issue. Cheaper, lesser quality prosthetics that frequently need replacing reap no #ROI for anyone! They also degrade #QualityofLife for patients. kffhealthnews.org/news/article...

5 Issues Associated with Medical Necessity Medical Necessity | Edits There are few things more frust...

BHM Healthcare @BHMHealthcare 20s
5 Issues with #MedicalNecessity bhmpc.com/2014/08/5-issues-associa... …