Agency Releases Prior Authorization Reporting Guidance with AMA Support

Agency Releases Prior Authorization Reporting Guidance with AMA Support

The Centers for Medicare and Medicaid Services (CMS) released guidance clarifying its expectations for the impacted payers that must report certain prior authorization metrics beginning this year pursuant to the 2024 Interoperability and Prior Authorization final rule. The rule includes Medicare Advantage organizations, Medicaid and CHIP programs, Medicaid and CHIP managed care, and Qualified Health Plan issuers on the Federally-facilitated Exchanges. In the… (McClurg, August 19, 2026) #Health Information Technology