Prior Authorization and Federal Updates
Summary
Presented at the NAIC Spring Meeting 2024, this document covers issues related to prior authorization (PA) processes and federal updates affecting health insurance. It highlights fundamental problems with PA, such as burdensome provider processes and inappropriate review criteria, and discusses the new CMS interoperability rule for electronic PA. The presentation also reviews the shortcomings of the CMS rule and suggests steps states should take to improve PA processes and compliance.
