Washington, D.C. – December 6, 2022 – Matt Eyles, President and CEO of AHIP, issued this statement in response to the Centers for Medicare & Medicaid Service’s (CMS) proposed rule released today, regarding Advancing Interoperability and Improving Prior Authorization Processes. This proposed rule would require, among other things, deployment of electronic prior authorization technology, and development of an application programming interface for insurance providers to share clinical and claims data with each other as consumers change from one plan to another:
“Every American should have the personalized health care information they need, so they can make better, more informed decisions before they seek and receive care. We applaud CMS for putting patients first with a proposed rule that allows them to easily to share their data with entities of their choosing.
“AHIP’s Fast PATH demonstration showed that electronic processes for prior authorization are essential for ensuring that patients receive swift, evidence-based care that improves value and reduces administrative burdens for everyone. This proposed rule would require clinicians and hospitals to adopt electronic prior authorization to meet certain quality measures, ensuring that we are all incentivized to work together for a better patient and clinician experience that improves satisfaction, efficiency, and affordability for everyone.
“Protecting patient privacy is paramount. It is important to note that a gap remains in our nation’s privacy framework. Personal health information shared with entities that are not required to comply with HIPAA will not be as robustly protected as other health care data. We strongly recommend that CMS work with Congress to address this gap.
“Americans should have clear, concise, and customized information with streamlined processes that improve health care quality, affordability, and accessibility. Health insurance providers are committed to delivering for them, and we look forward to continued partnership with the Administration on these important issues.”
Read more about Fast PATH for improved prior authorization.