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AANS and CNS Call on CMS to Reduce the Prior Authorization Burdens

The AANS and the CNS joined the AMA, ACS and other physician organizations in sending a letter to CMS calling on the agency to broaden its efforts to reduce the burdens associated with prior authorization. The letter notes medicine’s concerns that CMS is placing too much emphasis on automation as a means for streamlining prior authorization (PA). While an essential component, automation is but one element of reforms that are necessary to reduce the burdens of PA. The letter also urges CMS to facilitate payer adoption of the following principles:

  • Selective application of PA to only “outliers”;
  • Review/adjustment of PA lists to remove services/drugs that represent low-value PA;
  • Transparency of PA requirements and their clinical basis to patients and physicians;
  • Protections of patient continuity of care; and
  • Automation to improve PA and process efficiency.