CMS urged to cut prior authorization red tape

The American Hospital Association is asking CMS to give providers a break on prior authorization requirements.

One way to cut the red tape is for CMS to standardize its requirements, the association said.

"CMS could pursue standardization without compromising health plans' ability to manage benefits or create compelling products for the market," the association wrote in a letter to CMS Administrator Seema Verma.

The association suggested that CMS work with stakeholders to identify services that could be eligible for prior authorization, and health plans follow a common schedule for updating services requiring these authorizations.

Health plans should accept prior authorization requests using a standardized form and return prior authorization responses in the same way, the association recommended.

Read all of the association's recommendations and comments here.


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