In response to the Center for Medicare and Medicaid Services’ (CMS) recent proposed rule concerning Medicare Part C & Part D, ASCP joined with the AMA and more than 120 physician organizations in a sign-on
letter to CMS supporting the proposed reforms of prior authorization to the Medicare Advantage and the Medicare prescription drug benefit programs.
Our comments on the rule applauded CMS for recognizing concerns about the impact of prior authorization requirements on patient care and provider practice. The rule outlines several important reforms that go beyond what is specified in AMA’s
Prior Authorization Principles and Consensus Statement, of which ASCP is a supporter.
Topics covered in our letter include ensuring timely access to care, network adequacy, protecting beneficiaries, strengthening quality, advancing health equity, and health IT standards. Assuming the proposal is adopted by CMS, it will increase access to medically necessary care for beneficiaries covered by Medicare Advantage and, hopefully, reduce provider burden.
CMS has also released another rule proposing reforms to its prior authorization policies to other aspects of the Medicare program. ASCP is currently reviewing this rule and will be working with AMA on a response.
