CHA submitted comments on the Centers for Medicare & Medicaid Services’ (CMS) proposed rule to streamline prior authorization processes for Medicare Advantage, Medicaid managed care, and federally facilitated marketplace health plans.
In the letter, CHA was generally supportive of the proposals to improve the prior authorization process and offered specific comments on:
- Implementation of application programming interfaces for prior authorization requirements, documentation, and decision
- The requirement for payers to provide the status of prior authorization and reason for denial of prior authorizations
- Requirements for prior authorization decision time frames and communications
- Public reporting of prior authorization metrics
- Electronic prior authorization for the Medicare Promoting Interoperability Program
CHA appreciates member input that helped inform comments.