Here are four important prior authorization changes proposed or taking effect in 2023 for physician leaders to know:
- UnitedHealthcare changed its prior authorization rules for gastroenterology care, taking effect in June.
- CMS has proposed several prior authorization improvements, including new decision-making timeframes, publicly available metrics and new standards for exchanging medical data.
- 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.
- Blue Cross Blue Shield of Massachusetts completed its FastPass pilot, an artificial intelligence-powered automated prior authorization process.