Becker's Healthcare January 17, 2024
CMS has finalized prior authorization and electronic health information policy updates that are expected to create approximately $15 billion in savings over the next 10 years.
The CMS Interoperability and Prior Authorization Final Rule makes four key changes to the prior authorization process, according to a Jan. 17 CMS news release:
• All payers must implement a standardized prior authorization programming interface to make payer-provider prior authorization processes more efficient from end to end.
• All payers must provide specific reasonings for denying prior authorization requests to make resubmissions or appeals more efficient.
• It also requires affected payers to send prior authorization decisions within 72 hours by 2026.
• Payers under CMS jurisdiction must publicly report prior authorization...
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