MGMA urges adoption of operating rules to improve prior auth

Washington Connection - October 14, 2020

Health Information Technology

Oct. 8, 2020: MGMA joined the American Hospital Association, the American Medical Association, and the Arthritis Foundation calling on the National Committee on Vital and Health Statistics (NCVHS) to endorse proposed operating rules to reduce burdens associated with prior authorization. NCVHS, a federal advisory body, is currently deliberating whether to recommend national adoption of operating rules that would set new data content and timing mandates on health plans, including a requirement that plans respond within two business days following an authorization request from a practice and respond with the additional documentation needed to complete the request. Under the proposal, plans would also have a maximum of two business days to send a final determination once they receive all requested information.
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