CMS Rule Targets Prior Authorization with Interoperability

CMS Rule Targets Prior Authorization with Interoperability

Today, the Centers for Medicare & Medicaid Services (CMS) passed a final rule that promotes data sharing, patient access to health information, coordinated care, and interoperability to streamline the prior authorization process.The rule is the next phase of CMS interoperability rulemaking, aimed at improving data exchange while reducing provider and patient burden.The CMS Interoperability and Prior Authorization rule will allow certain payers, providers, and patients to have electronic access to pending and active prior authorization decisions. This is expected to cut back on repeated requests for prior authorizations, thereby reducing costs and administrative burden so providers can deliver higher quality care.

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