CMS Proposes New Prior Authorization Requirements for Payers, Including MA Plans

CMS

The CMS has issued a new rule meant to streamline prior authorization by requiring certain payers to implement an electronic prior authorization process and respond to requests more quickly.

The rule would also require payers to put in place standardized data exchange processes, to help them exchange data when a patient changes health insurers. If finalized, the policies would take effect in 2026, Healthcare Dive reports.

The rule, which the CMS estimates will save hospitals and doctor’s offices more than $15 billion over 10 years, replaces one proposed in the final days of the Trump administration that was controversial with health insurers. Read more.

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