News Briefs

On Jan. 15, CMS finalized a rule that compels Medicaid, CHIP and Affordable Care Act (ACA) exchange plans to streamline their prior authorization processes. The regulation, which the administration proposed in December (HPW 12/18/20, p. 1), would also require the affected plans to add new capabilities to the Patient Access APIs that they had to build in order to comply with a previously finalized data interoperability rule. Read more at https://go.cms.gov/2LDw8eL.

CMS on Jan. 14 finalized several provisions in the 2022 Notice of Benefit and Payment Parameters (NBPP), cementing controversial new regulations for the ACA exchanges. Payer trade groups criticized the draft rule on various points, particularly an unusually short comment period and a provision that would allow states to abandon a centralized health insurance exchange in favor of relying on brokers, agents and insurers (HPW 1/8/21, p. 5). While that provision was among those finalized, CMS said it “anticipates continuing to review comments and finalizing other proposed policies in a second final rule to be published at a later date.” Read more at http://go.cms.gov/3sku3Vs.

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AIS Health Staff

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