New Prior Authorization Proposal Is Likely Here to Stay

Building on previously finalized regulations aimed at advancing data interoperability in health care, CMS on Dec. 10 proposed a new rule that would require certain health plans to make their prior authorization processes more efficient and share even more data with providers and patients.

Although the proposal is arriving in the waning days of the Trump administration, it will likely survive the transfer of executive power, one health policy expert tells AIS Health. As for the affected health plans, complying with the new directives probably won’t take a herculean effort considering they’re already doing so much to modernize their data systems to align with the new interoperability mandates, another expert says. However, preparing to comply with all the new requirements is going to be challenging.

© 2021 MMIT

Leslie Small

Leslie has been reporting and editing in various journalism roles for nearly a decade. Most recently, she was the senior editor of FierceHealthPayer, an e-newsletter covering the health insurance industry. A graduate of Penn State University, she previously served in editing roles at newspapers in Pennsylvania, Virginia and Colorado.

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