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Medical Group Management Association

Jan. 4, 2021: MGMA statement on CMS proposed rule on prior authorization

- January 4, 2021

Medicare Payment Policies

Health Information Technology

Federal Compliance

FOR IMMEDIATE RELEASE CONTACT: Chad Clinton
January 4, 2021 202.262.1067; cclinton@mgma.org


MGMA statement on CMS proposed rule: Reducing Provider and Patient Burden by Improving Prior Authorization Processes and Promoting Patients’ Electronic Access to Health Information

 
Anders Gilberg

Senior Vice President, Government Affairs

Medical Group Management Association

 
By excluding most insurers from its regulation to alleviate prior authorization burdens, CMS proposes to do little to address health plan abuses that delay and deny patient care. The proposed 7-day turnaround time for “standard” prior authorization requests creates such a nominal requirement, it will do little to protect patients and reduce provider burden. With new automation standards available, there is great potential to improve health information exchange and streamline onerous prior authorization processes in the United States, but all health plans must be subject to the same rules that prioritize patients over paperwork.
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