Significant CMS Prior Authorization Changes on the Horizon: Your Voice Needed

Please comment on Prior Auth!

Recently CMS has begun a campaign to better regulate insurer’s ability to use prior authorization – numerous rules have been proposed, but one in particular needs action from APTA members. CMS is proposing to dramatically streamline the prior authorization process across multiple plans that involve federal funds.  The rule will require Medicare Advantage plans, Medicaid and CHIP plans and ACA marketplace plans to automate certain components of their prior authorization process and respond to requests within a certain timeframe – among other proposals. APTA members need to go on the record in support of these rules and encourage CMS to go even farther. We strongly recommend that APTA members use our resources to draft their own comment letter highlighting their experiences with prior authorization and advising the agency on how to improve the process for providers and patients alike. Read more here, and here. And visit the APTA Regulatory Action Center to take action.