On January 17, 2024, the Centers for Medicare & Medicaid Services (CMS) released a final rule that will require certain payers to automate their prior authorization processes and implement application program interfaces (APIs) to improve the exchange of health information among payers, providers and patients. The rule outlines these new requirements, exceptions to the requirements and implementation deadlines. It also adds a new electronic prior authorization measure that clinicians and hospitals must report as part of the Merit-based Incentive Payment System (MIPS) Promoting Interoperability Category and the Medicare Promoting Interoperability Program, respectively.
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