Prior Authorization
American Hospital Association (AHA) resources on health care insurance prior authorization, the impact of insurers' delays and rejections on patients, and the cost of these delays to hospitals and health systems.
While the AHA strongly supports CMS’ goal of modernizing prior authorization and extending interoperability requirements, the effectiveness of these policies will depend on thoughtful implementation that aligns with clinical workflows, ensures consistent payer behavior and meaningfully reduces…
AHA Comments on the Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule
The Centers for Medicare & Medicaid Services Oct. 21 announced that Amazon, Axon Enterprise, Inc., Google, Meta and Oracle Corp. are in support of its prior authorization pledge announced last year.
As major provisions of the 2024 Centers for Medicare & Medicaid Services Interoperability and Prior Authorization Final Rule take effect on Jan. 1, 2027, hospitals and health systems are advised to begin preparing for significant changes to prior authorization workflows, payer interactions and…
Skyrocketing prior authorization requirements have placed an acute burden on hospitals and patients alike.
The Workgroup for Electronic Data Interchange has launched its fall 2026 survey to assess industry readiness for the Centers for Medicare & Medicaid Services’ interoperability and prior authorization final rule.
The American Hospital Association hosted a webinar featuring representatives from the Centers for Medicare & Medicaid Services (CMS) and Epic to discuss federal requirements for electronic prior authorization that will take effect on January 1, 2027. Experts discussed how hospital and health…
AHA, CMS webinar explores how hospital and health system leaders can prepare for Medicare Advantage’s new electronic prior authorization mandate, which goes into effect Jan. 1, 2027.
AHA comments on NAIC Health Care Affordability Issue Briefs.
AHA comments on the CMS’ hospital outpatient prospective payment system and ambulatory surgical center payment system proposed rule for calendar year CY 2027.