On Wednesday, U.S. President Joe Biden’s administration finalized a rule requiring government backed-insurance plans such as Medicare Advantage organizations, Medicaid, Children’s Health Insurance Program (CHIP) fee-for-service programs, Medicaid managed care plans, CHIP managed care entities, and issuers of Qualified Health Plans offered on the Federally-Facilitated Exchanges, to improve the electronic exchange of health information and prior authorization processes for medical items and services.
The Centers for Medicare & Medicaid Services (CMS) said the rule will begin primarily in 2026.
CMS notes that these policies will improve prior authorization processes and reduce the burden on patients, providers, and payers, resulting in approximately $15 ...