CMS receives payer pushback on final interoperability and prior authorization rule

The Facilities for Medicare and Medicaid has finalized its interoperability and prior authorization rule, just above a month right after it was proposed.

The rule is intended to strengthen the way facts is shared among stakeholders to simplicity the burden vendors have when in search of prior authorizations, eventually liberating them to devote additional time with patients.

It will involve Medicaid, CHIP and specific sector Qualified Health Strategies (QHP) payers to establish, implement and retain software programming interfaces (APIs) that can help service provider access to their patients’ facts and streamline the prior authorization system.

Whilst Medicare Benefit plans are not provided in this ultimate rule, CMS mentioned it was thinking of which includes them in upcoming rulemaking.

What is THE Impact

Prior authorization – an administrative system made use of in health care for vendors to ask for acceptance from payers to give a medical provider, prescription, or provide

Read More