Healthcare DIVE December 7, 2022
Rebecca Pifer

Dive Brief:

  • The CMS has issued a new rule meant to streamline prior authorization by requiring certain payers to implement an electronic prior authorization process and respond to requests more quickly.
  • The rule would also require payers to put in place standardized data exchange processes, to help them exchange data when a patient changes health insurers. If finalized, the policies would take effect in 2026.
  • The rule, which the CMS estimates will save hospitals and doctor’s offices more than $15 billion over 10 years, replaces one proposed in the final days of the Trump administration that was controversial with health insurers.

Dive Insight:

The CMS is once again tackling prior authorization in its new rule proposed Tuesday. Prior authorization, a...

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Topics: CMS, Govt Agencies, Insurance, Medicare Advantage, Payer, Provider
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