Providers want more time to understand prior authorization changes
Modern Healthcare Illustration / Getty Images
Healthcare insiders are pressing the Trump administration to extend the public comment period for a proposed rule that aims to reform prior authorization and improve patient and provider access to medical records, according to comments on the proposed rule due Monday.
CMS on Dec. 10 unveiled its plan to require payers including Medicaid, the Children s Health Insurance Program and exchange plans to build application program interfaces to support data exchange and prior authorization. It said the changes would allow providers to know in advance what documentation each payer would require, streamline documentation processes and make it easier for providers to send and receive prior authorization information requests and responses electronically.
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Payer groups on Monday slammed a CMS proposed rule to streamline the prior authorization process, arguing the comment period was unreasonably and perhaps illegally short, the effective dates were unrealistic and the rule heaps further burden on a health system still digesting other regulatory changes while swamped by the coronavirus pandemic.
The rule first proposed in mid-December is part of the Trump administration s push to improve the electronic exchange of health data between payers, providers and patients, and builds off massive interoperability regulations finalized in March.
It focuses on standardizing and speeding the prior authorization process, in which a physician must get the green light from a patient s insurer for medication or treatment before administering it.
Rep. Cuellar sworn into 117th Congress
Courtesy of Rep. Henry Cuellar s Office
Jan. 6, 2021
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Rep. Henry Cuellar is sworn in as Texas’ District 28 congressman.Courtesy /Rep. Henry Cuellar’s Office
Washington, D.C. Rep. Henry Cuellar (TX-28) was sworn in as Texas’ District 28 Congressman to the 117th Congress.
The Congressman released the following statement:
“I am honored to continue to represent Texas’ 28th in Washington for the next two years. A great deal of work lies ahead, but I remain steadfast in my commitment to working every day to advance the priorities of my constituents.
“I will fight for the support that our families require as we continue to battle the COVID-19 crisis, including additional federal funding to ensure vaccines are distributed to every American. I will protect and expand affordable health care, particularly for the thousands of South Texans with pre-existing conditions. I will make sure every child has the opportunit