CMS is considering proposals that would cut the number of procedures that are subject to prior authorization, Bloomberg reported April 29.
Five things to know:
1. People familiar with the discussions told Bloomberg that CMS is exploring making prior authorization policies more uniform across different health insurance plans. The agency is also exploring the use of automation for coverage determinations to help patients receive quicker decisions.
2. It is uncertain whether CMS would pursue regulatory mandates or rely on insurers to voluntarily adopt changes, according to the report.
3. Former CMS acting administrator Andy Slavitt has discussed the policy with agency leadership and recommended pursuing new regulations.
4. The discussions are in the preliminary stages, and CMS’ direction could change, according to the report.
5. A CMS spokesperson told Bloomberg that the agency is “committed to cutting down on unnecessary delays” for seniors seeking medical care, but “any statements about a specific set of principles or decisions are premature at this point.”
Read the full report here.
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