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CMS announces proposed rule to improve electronic data exchange and streamline prior authorization | Bricker & Eckler LLP

To embed, copy and paste the code into your website or blog: On December 11, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule designed to improve electronic health care data exchange and streamline the prior authorization process. The CMS fact sheet accompanying the proposed rule stated that its goal is “reducing overall payer and provider burden and improving patient access to health information.” The proposed rule includes five sets of proposals and five requests for information. The proposals include the following: Patient Access Application Programming Interface (API) – This proposal builds on the Interoperability and Patient Access final rule, which required certain payers to implement a Fast Healthcare Interoperability Resources-based Patient Access API. CMS would now require these payers to include information about patients’ pending and active prior authorization decisions in the API. These payers would also be required to maintain

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CMS Proposes New Rules Around Prior Auths

email article The Centers for Medicare and Medicaid Services (CMS) proposed a new rule Thursday that aims to ease clinicians workload by streamlining prior authorizations (PAs) giving clinicians more time to see patients. If you re a physician, you probably already knew that because you already do PAs or have tasked your staff with them, and, based on our survey, you really, really hate them!! Each element of this proposed rule would play a key role in reducing onerous administrative burden on our frontline providers while improving patient access to health information, said CMS Administrator Seema Verma, in a press release.

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