Medicare will require more prior authorization in some states

Residents of Washington and five other states enrolled in traditional Medicare could soon need preapproval for certain medical services — a familiar hurdle for commercial insurance plans, including Medicare Advantage, but until now largely absent from traditional Medicare.

The Centers for Medicare & Medicaid Services says the prior authorization requirement, beginning Jan. 1, aims to cut spending on unnecessary or low-value care. It’s being tested in six states — which include New Jersey, Ohio, Arizona, Texas and Oklahoma. If the experiment is deemed a success, the requirements could roll out to other states.

Prior authorization requires doctors to get approval from health insurers before performing certain procedures. Medicare Advantage and commercial insurance plans often require preap