Ep. 904 - PRIOR AUTHORIZATION; causing misery for sick people under MA, comes to Original Medicare! episode artwork

EPISODE · Jan 24, 2026 · 39 MIN

Ep. 904 - PRIOR AUTHORIZATION; causing misery for sick people under MA, comes to Original Medicare!

from Medicare For The Lazy Man Podcast · host Douglas B. Jones, CLU, RHU with Randy Carson of C2C Consulting

MEDICARE ADVANTAGE MINUTE:                                                                      CMS (THE FEDERAL GOVERNMENT) TIGHTENS MEDICARE ADVANTAGE PRIOR AUTHORIZATION RULES!                                                                                              Before that we discuss the qualities of certain members of England's Royal Family. January 1st saw a pilot program begin, creating prior authorization requirements for a few procedures performed under Original Medicare in six states. The program will be testing whether enhanced technologies like AI and machine learning can streamline prior authorizations and medical reviews. New, soon-to-be-client Sheryl, is taking a very cerebral approach to the concept of Medicare supplement rate stability. She discovered a site called: SERFF.com and is trying to identify those Medicare supplement plans with less rate stability, which most would prefer to avoid. Inadvertently, she uncovered a pattern that confirms my repeated assertion about Plan G vs. High Deductible Plan G: Plan G increases will be larger and more frequent while the rate increases under HDG will tend to be smaller and less frequent. Finally, I received six messages inviting me to be a guest on a brand new podcast. I was offered the opportunity to program the time for an initial chat but could not figure out how to use the scheduling app.  Stay tuned!        Contact me at: [email protected] (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2026; SIMPLEST & EASIEST GUIDE EVER!" "MEDICARE DRUG PLANS: A SIMPLE D-I-Y GUIDE" "MEDICARE FOR THE LAZY MAN: ENROLLMENT GUIDE!" (coming soon) For sale on Amazon.com. After enjoying the books, please consider returning to leave a short customer review to  help future readers. Official website: https://www.MedicareForTheLazyMan.com.

MEDICARE ADVANTAGE MINUTE:                                                                      CMS (THE FEDERAL GOVERNMENT) TIGHTENS MEDICARE ADVANTAGE PRIOR AUTHORIZATION RULES!                                                                                              Before that we discuss the qualities of certain members of England's Royal Family. January 1st saw a pilot program begin, creating prior authorization requirements for a few procedures performed under Original Medicare in six states. The program will be testing whether enhanced technologies like AI and machine learning can streamline prior authorizations and medical reviews. New, soon-to-be-client Sheryl, is taking a very cerebral approach to the concept of Medicare supplement rate stability. She discovered a site called: SERFF.com and is trying to identify those Medicare supplement plans with less rate stability, which most would prefer to avoid. Inadvertently, she uncovered a pattern that confirms my repeated assertion about Plan G vs. High Deductible Plan G: Plan G increases will be larger and more frequent while the rate increases under HDG will tend to be smaller and less frequent. Finally, I received six messages inviting me to be a guest on a brand new podcast. I was offered the opportunity to program the time for an initial chat but could not figure out how to use the scheduling app.  Stay tuned!        Contact me at: [email protected] (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2026; SIMPLEST & EASIEST GUIDE EVER!" "MEDICARE DRUG PLANS: A SIMPLE D-I-Y GUIDE" "MEDICARE FOR THE LAZY MAN: ENROLLMENT GUIDE!" (coming soon) For sale on Amazon.com. After enjoying the books, please consider returning to leave a short customer review to  help future readers. Official website: https://www.MedicareForTheLazyMan.com.

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Ep. 904 - PRIOR AUTHORIZATION; causing misery for sick people under MA, comes to Original Medicare!

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This episode was published on January 24, 2026.

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MEDICARE ADVANTAGE MINUTE:                                                                      CMS (THE FEDERAL GOVERNMENT) TIGHTENS MEDICARE ADVANTAGE PRIOR AUTHORIZATION RULES!                                                                     ...

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