From groups weighing in on CMS' proposed rule to reform the process, to UnitedHealthcare announcing plans to eliminate 20 percent of its current requirements, here are 10 updates about prior authorization Becker's has reported since March 13:
1. CMS issued a final rule that, among other things, aims to streamline Medicare Advantage and Part D prior authorizations and clamp down on misleading marketing practices.
2. Peter Lee, PhD, corporate vice president of research and incubations at Microsoft, said GPT-4, an AI-powered tool built by OpenAI, could potentially be used to generate prior authorization requests.
3. UnitedHealthcare is moving forward with a plan to eliminate 20 percent of its current prior authorizations and implement a national gold-card program.
4. Ninety-four percent of physicians reported that prior authorization led to delays in patient care and has caused increased administrative burden, a survey from the American Hospital Association found.
5. The American Gastroenterological Association is asking its members to contact UnitedHealthcare to stop new prior authorization requirements from going into effect.
6. Kansas lawmakers are considering legislation backed by the Kansas Hospital Association that would reform the prior authorization process.
7. Mississippi Gov. Tate Reeves vetoed a bill that aimed to speed up the prior authorization process.
8. The American Hospital Association had urged CMS to finalize its proposed rule for reforming the prior authorization process but suggested some changes, including shortening the amount of time payers have to make a determination.
9. The Medical Group Management Association said it wanted to see shorter prior authorization time frames in CMS' finalized reform rule.
10. Eight-eight percent of physicians say prior authorization requirements are a large burden and lead to worse patient outcomes, according to a survey from the American Medical Association.