HMP Global December 3, 2024
Prior authorization (PA) remains one of the most debated aspects of modern health care. Intended to ensure that treatments and services are medically necessary and cost-effective, the process is often criticized for causing administrative burdens, delaying care, and straining the relationships between health care providers and payers. In 2024, PA became a focal point for both regulatory action and technological innovation.
The Centers for Medicare and Medicaid Services (CMS) finalized the Interoperability and Prior Authorization Rule (CMS-0057-F) in January 2024, signaling a major shift in how PA will function in the future. The rule, designed to reduce delays and improve transparency, mandate faster decision-making, streamline data sharing, and enhance interoperability, specifying that certain provisions must be in effect by January...
Today's Sponsors
Today's Sponsor