How CMS is digitizing prior authorizations to save $15B

Becker's Healthcare March 21, 2024
Giles Bruce

CMS is aiming to solve one of healthcare’s most perplexing — and time-consuming — issues: the dreaded prior authorization.

The agency plans to expedite prior authorizations, through digitization and better data exchange, saving the healthcare industry $15 billion over a decade — in the hopes of one day having the decisions made instantaneously, right in the EHR.

Becker’s caught up with Alexandra Mugge, chief health informatics officer at CMS, to learn more about how the agency intends to meet such an ambitious goal.

Question: What is CMS doing to speed up prior authorizations?

Alexandra Mugge: We recently finalized the CMS Advancing Interoperability and Improving Prior Authorization Processes final rule, which both streamlines the existing prior authorization process and moves the...

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