CMS released the Interoperability and Prior Authorization Final Rule, which includes critical policies supported by the Federation of American Hospitals (FAH) for protecting patients. Key provisions in the rule include establishing required response times for prior authorization requests, publicly reporting metrics on prior authorization denials and appeals, and improving the process by requiring use of electronic transfer of prior authorization requests and communications.

Chip Kahn, FAH President and CEO, said the following on the release of the final rule:

“Patients need protection from arbitrary critical care denials and delays due to insurance company prior authorization abuse. It is important that CMS is taking a vital step to ensuring this protection by setting guardrails for prior authorization that should rein-in the worst abuses. We urge Congress to further attack prior authorization abuse and protect access to care by passing the bipartisan Ensuring Seniors’ Timely Access to Care Act.”