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Committee reviews and recommends approval of four Medicaid 'gold‑card' prior‑authorization policies
Summary
Representatives of Summit Community Care, Empower, CareSource and Arkansas Total Care presented gold‑card prior authorization policies under Act 575; the committee recommended approval of each plan's policy by voice vote and asked for clearer lists of services and appeals procedures.
Four provider‑led managed‑care organizations appeared before the Public Health, Welfare and Labor Committee to present policies aimed at reducing prior‑authorization burden under Act 575, the 2023 law that created a gold‑card exemption for high‑performing providers.
Mitch Morris, CEO of Empower Healthcare Solutions, said provider‑led plans were exempt from the statute only if they submit a plan to reduce prior authorizations, and described a gold‑card approach tied to provider performance. "We were exempted from Act 575 as long as we prepare a policy designed to reduce and in some cases lessen prior authorizations for our network of providers," he…
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