On December 6, 2022, the Centers for Medicare & Medicaid Services (CMS) proposed a rule—the Interoperability and Patient Access final rule—that introduces new requirements for health care payers aiming to enhance patient data sharing and streamline the prior authorization process. The rule would require certain payers to digitize their prior authorization process, shorten the timeline for payers to respond to prior authorization requests, report specific reasons for denying any authorization requests, make their prior authorization metrics publicly available so providers and patients can understand them, and require certain payers to share data with each other.
In a new webinar—the fourth in our health care litigation series—Manatt Health will explain the proposed rule and its implications. Key topics that will be covered include:
- The current rules and regulations for prior authorization of urgent and nonurgent services
- How those rules would change if the CMS Interoperability and Patient Access rule is implemented
- Which entities are impacted by the proposed rule
- Requests for Information CMS is currently soliciting from payers and providers in the proposed rule
- Timeline for implementation of the rule and what payers should start doing to prepare for compliance
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