CMS Releases Prior Authorization Proposed Rule | SCAI

On Tuesday, December 6, 2022, the Centers for Medicare and Medicaid Services (CMS) issued the Advancing Interoperability and Improving Prior Authorization Process Proposed Rule. The rule applies to Medicare Advantage and Medicaid plans, and requires the plans establish an electronic authorization process. The rule also requires the plans to shorten time frames for responding to authorization requests and provide reasons for denials. SCAI applauds CMS for releasing the proposed rule and will provide comments by the March deadline. 

SCAI continues to push for passage of the Improving Seniors’ Timely Access to Care Act to reform the Medicare Advantage prior authorization process. SCAI awaits a new, and hopefully lower, CBO score based on the proposed rule which could help the bill gain passage in the Senate.

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