CMS Innovation Center releases FAQ on prior authorization program pilot
The Centers for Medicare & Medicaid Services Innovation Center Aug. 12 released an FAQ on the Wasteful and Inappropriate Service Reduction Model, a six-year technology-enabled prior authorization program pilot. CMS will partner with third-party entities to implement the program for a specified list of services delivered to patients with Original Medicare. The FAQs address patient rights, the coverage review process for beneficiaries and providers, safeguarding against inappropriate denials, protecting patient data and more. The model begins Jan. 1.
Related News Articles
Headline
An AHA blog published July 28 highlights new electronic prior authorization requirements that begin Jan. 1, 2027, as a result of the Centers for Medicare…
Blog
As major provisions of the 2024 Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization final rule take effect next year,…
Blog
Americans experience healthcare affordability in different ways. Often, affordability is first considered in terms of health insurance premiums that fit within…
Headline
The AHA provided comments June 15 to the Centers for Medicare & Medicaid Services on its proposed rule establishing electronic standards for drug prior…
Headline
The Medicaid and CHIP Payment and Access Commission June 15 released its June 2026 report to Congress. Among the topics discussed, chapter two focuses on…
Headline
The Centers for Medicare & Medicaid Services May 13 announced 29 health care organizations have pledged early participation in its electronic prior…