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.
An AHA blog published July 28 highlights new electronic prior authorization requirements that begin Jan. 1, 2027, as a result of the Centers for Medicare & Medicaid Services’ 2024 Interoperability and Prior Authorization final rule.
As major provisions of the 2024 Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization final rule take effect next year, hospitals and health systems should begin preparing for changes to prior authorization workflows, payer interactions and information exchange…
The American Hospital Association shares the hospital field’s comments on legislation being marked up by the Energy and Committee on July 21.
Unacceptably, millions of Americans are struggling with healthcare costs. Many have chosen to skip prescriptions or other needed care because of concerns about costs; 4 in 10 Americans have medical debt.
The AHA provided comments June 15 to the Centers for Medicare & Medicaid Services on its proposed rule establishing electronic standards for drug prior authorizations.
The Medicaid and CHIP Payment and Access Commission June 15 released its June 2026 report to Congress.
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…
The Centers for Medicare & Medicaid Services May 13 announced 29 health care organizations have pledged early participation in its electronic prior authorization initiative.
A majority of physicians say the prior authorization process continues to negatively impact patient outcomes and employee productivity, according to a survey released May 13 by the American Medical Association.
The Medicaid and CHIP Payment and Access Commission approved recommendations it will issue to Congress in its June report on oversight and increased transparency of artificial intelligence usage for prior authorization.