tci Medicare Compliance & Reimbursement - 2024 Issue Q1

Prior Authorization: Final Rule Aims To Improve Interoperability And Access To Care

Plus: Feds finalize new API requirements and a MIPS measure, too. After the pandemic revealed systemic issues with access to care, the feds have tried to right this problem with new policies and programs. In the latest rule, Medicare embraces technology to improve coordination between providers, hoping to bolster equity and timely access to care. Background: On Feb. 8, the Centers for Medicare & Medicaid Services (CMS) published a regulation in the Federal Register titled the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F). The rule harnesses digital tools, increases tech requirements, and streamlines prior authorization processes. The finalized...

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