A bipartisan Congressional majority is putting pressure on CMS to finalize a federal regulation that would overhaul prior authorization within Medicare Advantage, according to a July 24 report from the American Medical Association.
A bipartisan letter to the Department of Health and Human Services and CMS was co-signed by 61 senators and 233 representatives. It was also spearheaded by the AMA.
Congress is urging CMS to expand the proposed rule by establishing a system for real-time electronic prior authorization decisions, requiring plans to respond to requests within 24 hours in emergency cases and requiring detailed transparency metrics.
While the CMS prior authorization rule was originally proposed in December, the new letter urges the agency to finally formalize the proposal and strengthen its final regulations.