Fierce Health Technology October 20, 2021
The American Hospital Association (AHA) has formalized its request that the Centers for Medicare & Medicaid Services’ (CMS’) proposed regulations aimed at streamlining prior authorizations extend to Medicare Advantage plans, establish when prior authorization may be applied, further reduce response timelines and include stricter oversight of unnecessary delays.
Introduced in December, CMS’ proposed rule (PDF) would require payers in Medicaid, the Children’s Health Insurance Program (CHIP) and qualified health plans on the Affordable Care Act’s exchanges to build application programming interfaces to limit the administrative burden on providers submitting prior authorization requests.
These and other requirements in the proposed rule simplify the exchange of electronic documentation and hasten the speed with which providers receive a response so they can move...
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