CMS' new prior authorization final rule: 5 things ASCs need to know

Becker's Healthcare May 11, 2023
Patsy Newitt

CMS has issued a final rule to help streamline Medicare Advantage and Part D prior authorizations.

Here are five things to know, according to a CMS fact sheet released April 5:

1. Coordinated care plan prior authorization policies can only be used to confirm the presence of diagnoses and/or ensure it is medically necessary.
2. Coordinated care plans also must provide a minimum 90-day transition period when a beneficiary undergoing treatment switches to...

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