This summary includes key provisions that CMS has included in its Interoperability and Prior Authorization Proposed Rule with implications for children’s health and health care. The rule would place new requirements on state Medicaid and CHIP fee-for-service (FFS) programs, Medicaid managed care plans, CHIP managed care entities and Qualified Health Plan (QHP) issuers on the Federally Facilitated Exchanges (FFEs) (collectively “impacted payers”) to improve the electronic exchange of health-related data and streamline prior authorization processes.
Prior Authorization and Interoperability Proposed Rule Summary
CHA created a summary on a proposed rule to improve the electronic exchange of health-related data and streamline prior authorization processes.
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