CMS has finalized a new final rule that aims to shorten prior authorization timelines and streamline processes to remove barriers to patient care, according to a press release.
The rule will require prior authorization decisions to be sent within 72 hours for urgent requests, or 7 days for standard requests, according to the release from CMS. Denials will require a specific reason, and payers must report certain prior authorization metrics on their website.
The rule is set to be in force Jan. 1, 2026. CMS estimates it will result in (Read more...)