4 prior authorization updates for physician leaders to know

Here are four important prior authorization changes proposed or taking effect in 2023 for physician leaders to know: 

  1. UnitedHealthcare changed its prior authorization rules for gastroenterology care, taking effect in June. 
  2. CMS has proposed several prior authorization improvements, including new decision-making timeframes, publicly available metrics and new standards for exchanging medical data. 
  3. The Medical Group Management Association and the American Medical Association sent letters to CMS in February asking the agency to finalize proposed prior authorization reforms. 
  4. Blue Cross Blue Shield of Massachusetts completed its FastPass pilot, an artificial intelligence-powered automated prior authorization process. 

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