CMS Unveils Contentious Prior Authorization Reform Rule Proposals

 


Physicians and healthcare experts are urging Medicare to lead reforms in the time-consuming prior authorization (PA) process, which often causes delays in patient care. However, they caution against excessive reform, as it could exacerbate the problem rather than improving it.

The U.S. Centers for Medicare and Medicaid Services (CMS) have put forth two proposals for changes to the PA rules. Unfortunately, these proposals conflict with each other, potentially hindering the effort to streamline the consultation process between physicians and health insurers for the benefit of patient care. Instead of facilitating the process, CMS might inadvertently create more challenges.

The American Medical Association (AMA), the American Hospital Association (AHA), the AHIP health insurance provider trade group, and the Blue Cross Blue Shield Association have jointly written a letter to CMS Administrator, requesting federal regulators to address these potentially conflicting rule changes.

AHIP has pointed out a mismatch between the Administrative Simplification proposed rule and the Interoperability and Prior Authorization rule, both of which have been published in the Federal Register daily journal of the U.S. Government.

The health organizations expressed their gratitude for CMS’s December 2022 notice of proposed rulemaking (NPRM) aimed at adopting new electronic transmission standards for health care attachments. They also applauded CMS’s focus on reforming prior authorization (PA) to ensure timely access to care for patients and reduce manual paperwork for stakeholders in the healthcare industry.


https://www.allzonems.com/prior-authorization-reform-rule-proposals/


About Allzone management services:


Allzone Management Services is a leading Outsourcing medical billing and Outsourcing medical coding company that provides a wide range of services to healthcare providers. Allzone Management Services is committed to providing high-quality, accurate, and timely medical billing services to its clients. The company has a team of experienced and certified medical billers and coders who are familiar with the latest coding guidelines and regulations. Allzone Management Services also uses state-of-the-art technology to ensure that its clients' claims are processed quickly and efficiently.

In addition to its medical billing and coding services, Allzone Management Services also offers a variety of other services that can help healthcare providers improve their revenue. If you are a healthcare provider looking for a reliable and experienced medical billing and coding company, Allzone Management Services is a great option. The Revenue cycle management company offers a wide range of services that can help you improve your revenue and maximize your reimbursements.


Comments

Popular posts from this blog

2023 Scary ICD-10 Halloween codes For Physician

Medicare ASC Payment System 2024 Update: New HCPCS Codes & Changes

Medicare Billing Update: Boost Reimbursement with G2211 Add-On Code