CMS Encouraged to Reform Prior Authorization

On Oct. 28, Sens. Sherrod Brown (D-Ohio) and John Thune (R-S.D.) spearheaded a letter to CMS Administrator Chiquita Brooks-LaSure calling for improvements to the prior authorization process. Signed by 29 U.S. Senators, the bipartisan letter encourages the agency to streamline prior authorization protocols across government health programs, including Medicare Advantage, to make them more efficient. The AANS and the CNS issued a press release expressing support for the Senate letter.

Simultaneously with the Senate letter, the AANS and the CNS joined the Regulatory Relief Coalition (RRC) in a letter to CMS encouraging CMS to assess all utilization review programs — including prior authorization, step therapy and AUC for imaging — and to take appropriate action to improve and streamline these programs. The letter pointed out that the previous administration issued a proposed rule to, among other things, reduce provider and patient burden by adopting an electronic prior authorization program in Medicaid, the Children’s Health Insurance Program (CHIP) and the individual health insurance markets. The RRC urged the agency to finalize this rule and expand it to include the Medicare Advantage program. The coalition hopes to meet with CMS officials later this fall.

Click here to read the Regulatory Relief Coalition letter.