CMS Finalizes Interoperability and Prior Authorization Rule
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CMS Finalizes Interoperability and Prior Authorization Rule
January 27, 2024
All US-based consumers of Major Medical Insurance should be excited about this week’s announcement from the Centers for Medicare & Medicaid Services!
CMS released their Interoperability and Prior Authorization Final Rule (CMS-0057-F) which dictates standards for payer processing of prior authorizations as well as mandates for data sharing among payers and physicians and other clinicians. There’s good information in this article by Richard Payerchin in Medical Economics that shares some of the initial responses from the American Academy of Family Physicians (AAFP), the Medical Group Management Association (MGMA) and the Workgroup for Electronic Data Interchange WEDI .
Leap Consulting Group clients have participated in the drafting of this ruling and are excited to see it finalized. If you are curious to learn more about the digital implications of this ruling or any of the recent rulings coming out of CMS, let’s talk!
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