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CMS Proposes Rule to Require Certain Health Plans to Electronically Share Data with Providers Regarding Prior Authorization Requests | King & Spalding

On December 13, 2022, CMS is set to publish in the Federal Register a proposed rule (Proposed Rule) requiring certain Medicare, Medicaid, Children’s Health Insurance Program, and...
Medicare Promoting Interoperability Program Exchange Framework Children Health Insurance Program Health Plan Health Level Federal Register

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CMS Includes MAOs in Data Exchange and Prior Authorization Requirements | Sheppard Mullin Richter & Hampton LLP

The Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, “Advancing Interoperability and Improving Prior Authorization Processes” (the “Proposed Rule”), that is...
Centers For Medicare Data Exchange Requirements Data Exchange Requirements For Concurrent Coverage Data Exchange Children Health Insurance Program Medicaid Services

CMS Releases Data Exchange and Prior Authorization Rules Proposal

Centers for Medicare and Medicaid Services CMS issued proposed rule, Advancing Interoperability and Improving Prior Authorization Processes, to improve patient, provider access to health information, streamline processes for prior authorization for medical items, services.
Centers For Medicare Data Exchange Requirements Data Exchange Requirements For Concurrent Coverage Data Exchange Children Health Insurance Program Medicaid Services

CMS releases Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule

In a newly proposed rule, the Centers for Medicare and Medicaid Services is changing prior authorization standards to speed up the time it takes for payers to approve the requests and is implementing HL7 FHIR standards to support an electronic process. CMS is proposing to require certain payers, including Medicare Advantage organizations, to implement electronic prior
United States Matt Eyles Ashley Thompson Tochi Iroku Malize Erik Isakson Getty Mary Beth Donahue

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