On March 13, the Alliance of Specialty Medicine submitted comments to CMS generally supporting its Advancing Interoperability and Improving Prior Authorization proposed rule. The rule, which largely pertains to Medicare Advantage plans, Medicaid/CHIP Fee-for-Service (FFS) and managed care plans, and qualified health plans on the Federally-Facilitated Exchanges aims to improve the electronic exchange of data between payers, patients, and clinicians, and to streamline prior authorization processes through electronic data exchange requirements. The Alliance reiterated concerns about current prior authorization practices and expressed support for policies that aim to speed up prior authorization decision timeframes and increase transparency of payer prior authorization requirements and patterns. However, the Alliance also included recommendations on ways for CMS to strengthen its proposals, such as extending its proposals to drugs, adopting shorter prior authorization decision timeframes than proposed, and opposing a proposal to measure and hold physicians accountable for their use of electronic prior authorization processes. You can access the detailed letter by clicking on the link below.
Alliance – Advancing Interoperability and Improving Prior Authorization Proposed Rule Comments
