By Tony Schueth – The CMS pledge is big on vision but light on details about execution. That’s not unusual. Pledges are intended to inspire and drive change and innovation, but they do not provide a step-by-step playbook for achieving a goal.
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By Mary Griskewicz – At its core, HTI-4 is about making prescribing and medication access more real-time, transparent, and aligned with patient needs. It updates health IT certification criteria in three key areas: electronic prescribing, real-time prescription benefit (RTPB), and electronic prior authorization (ePA).
By Brady Bizarro Esq. – In a move that’s already generating buzz across the healthcare landscape, Health and Human Services Secretary Robert F. Kennedy, Jr. recently announced that the country’s largest health insurers have agreed to voluntarily streamline the controversial prior authorization process.
HHS Secretary Kennedy and CMS Administrator Oz press conference on securing industry pledges to fix the broken Prior Authorization System. They met with insurance leaders of nearly 80% of covered Americans.
By Kim Boyd – We focus on the aspects related to the pharmacy services arena: ePrescribing, electronic prior authorization, and real-time prescription benefit (RTPB). These elements are pivotal in improving patient access to medication and enhancing the efficiency and transparency of the prescription delivery process.
By Dr. Brian Covino – Adequate access to healthcare remains out of reach for many Americans. Despite progress, underserved communities continue to face significant barriers to quality care, often leading to poorer health outcomes.
March 26, 2024, from 1:00 to 2:00 PM ET: Register and join CMS for their virtual education session on the Interoperability and Prior Authorization final rule. Questions can be submitted beforehand via the registration form.
By David R. Burda – The long-running debate over prior authorization typically is framed around patient care. PA delays or denials prevent patients from receiving medically necessary care when they need it. Within that frame is the administrative burden that PA puts on physicians.
By Kim Boyd – On January 17, 2024, CMS unveiled the final rule aimed at advancing interoperability and enhancing prior authorization processes. This regulation leverages API technology to drive transparency, efficiency, and reduce provider, patient, and payer burden.