CMS Interoperability and Prior Authorization Final Rule Synopsis
The Centers for Medicare & Medicaid Services (CMS) changed its prior authorization rules to simplify and digitize the process, and to reduce the burden on each of the three legs in the healthcare delivery tripod: patients, providers, and payers. In particular, CMS aims to reduce administration, simplify and accelerate the process, and introduce standardization across payers.
It is critically important for providers and especially payers to get ahead of these changes by assessing processes and the technology necessary to support the rules change and ensure compliance.