On December 10, 2020, the Department of Health and Human Services released a notice of proposed rulemaking Reducing Provider and Patient Burden by Improving Prior Authorization Processes, and Promoting Patients’ Electronic Access to Health Information, which builds on the Centers for Medicare & Medicaid Services’ (CMS) Interoperability and Patient Access final rule released earlier this year. This new proposed rule includes additional proposed requirements for payers to implement standards-based application programming interfaces (APIs) that can help address critical health care challenges such as improving the efficiency of prior authorization processes.
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