The Centers for Medicare & Medicaid Services (CMS) seeks public input on new requirements for Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children’s Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges.
Proposals would require impacted payers to support electronic prior authorization for drugs, shorten decision timeframes, and increase transparency around authorization decisions. Also, the Office of the National Coordinator is using this rulemaking to propose adoption of updated versions of certain health information technology standards and specifications to be used across the Department of Health and Human Services, such as CMS’s interoperability requirements.
Comments due by June 15.