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Prior authorization has caused significant frustration for patients and physicians, imposing administrative burdens and often delaying or denying care. A new study finds that it is also highly effective in combating fraud.
Medicare reimburses ambulance rides for dialysis when patients have a medical need for assistance. However, ambulance companies can transport ineligible patients and receive reimbursements when verifying medical necessity is not required.
In 2014, Medicare began requiring physician prior authorization for repetitive, scheduled non-emergent ambulance transports. A study published in the Journal of Political Economy by