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CMS Finalizes its Proposal to Advance Interoperability and Improve Prior Authorization Processes

Healthcare Law Blog

Merit-based Incentive Payment System (“MIPS”) eligible clinicians, operating under the Promoting Interoperability performance category of MIPS, and eligible hospitals and critical access hospitals (“CAHs”), operating under the Medicare Promoting Interoperability Program, are impacted by the Final Rule, as well.

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CMS prior authorization rule finally crosses the finish line

Redox

While most of the rule focuses on payer requirements, it also requires that Merit-Based Incentive Payment System (MIPS) “Promoting Interoperability Program” eligible providers report on their use of Prior Authorization APIs in a new “Electronic Prior Authorization” measure. commercial plans, worker’s compensation, etc.)

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