WASHINGTON, D.C. – (April 12, 2023) – Matt Eyles, President and CEO of AHIP, issued this statement following the release by the Office of the National Coordinator for Health Information Technology (ONC) of HTI-1, the Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing Proposed Rule:
“Every American deserves access to high-quality affordable coverage and health care. Evidence-based medical management programs and services, including tools such as prior authorization, are key to delivering on that commitment, promoting the delivery of clinically appropriate high-quality care, reducing waste, and improving affordability for all Americans.
“That is why we are disappointed that the HTI-1 proposed rule would not require certified electronic health record technologies (CEHRT) to include electronic prior authorization (ePA). Studies and pilots have shown that moving to ePA can dramatically speed care for patients, reduce the burden of a paper-based system for patients and providers alike, and reduce costs. The implementation of ePA has already been proposed by the Centers for Medicare & Medicaid Services (CMS) as a requirement for health insurance providers and as a quality measure for health care providers. But without a similar requirement in HTI-1 for CEHRT vendors to build the capability for providers to access, health insurance providers are building ‘bridges to nowhere,’ adding administrative costs and waste into the health care system that will not benefit patients or providers.
“We urge ONC to quickly issue a second rule with ePA as a criterion for CEHRT on a timeframe in line with the CMS’ final requirements for health insurance providers to make available ePA.
“Health insurance providers are committed to using technology to streamline and improve evidence-based medical management programs and processes, such as prior authorization. CEHRT vendors and health care providers must share in these responsibilities for there to be any benefit for the patients they serve.”
AHIP is the national association whose members provide health care coverage, services, and solutions to hundreds of millions of Americans every day. We are committed to market-based solutions and public-private partnerships that make health care better and coverage more affordable and accessible for everyone. Visit www.ahip.org to learn how working together, we are Guiding Greater Health.