"US Government Expands Health Information Access and Streamlines Prior Authorization Process with New Rule"

The Centers for Medicare & Medicaid Services (CMS) has finalized a rule to streamline the prior authorization process for medical items and services, aiming to reduce patient and provider burden and save an estimated $15 billion over ten years. The rule sets requirements for various healthcare payers to improve electronic health information exchange and prior authorization processes, with a focus on expediting decisions and reducing administrative burden. Additionally, the rule mandates the implementation of Health Level 7 (HL7®) Fast Healthcare Interoperability Resources (FHIR®) Prior Authorization application programming interface (API) to facilitate a more efficient electronic prior authorization process between providers and payers.