Healthcare Finance News January 19, 2021
Rule requiring payers to implement APIs for data sharing and to streamline prior authorization is “half-baked,” AHIP says.
The Centers for Medicare and Medicaid has finalized its interoperability and prior authorization rule, just over a month after it was proposed.
The rule is intended to improve the way data is shared between stakeholders to ease the burden providers have when seeking prior authorizations, ultimately freeing them to spend more time with patients.
It will require Medicaid, CHIP and individual market Qualified Health Plans (QHP) payers to build, implement and maintain application programming interfaces (APIs) that can enable provider access to their patients’ data and streamline the prior authorization process.
Although Medicare Advantage plans are not included in this final rule,...
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