prior authorization

June 25, 2019

CMS Issues a Proposed Rule to Update E-prescribing Standards To Reduce Provider Burden and Expedite Patient Access To Needed Medications

On June 17, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would improve patients’ access to necessary medications by updating the prior authorization process for Medicare Part D, the program that provides coverage for prescription drugs that beneficiaries pick up at a pharmacy counter. The prior authorization process requires that providers supply additional clinical information to verify that the medication can be covered under the Medicare Part D benefit. The process is intended to promote better clinical decision-making and help ensure that patients receive medically necessary prescription drugs. The proposed rule would update the Part D e-prescribing program by adopting standards that ensure secure transmissions and expedite prior authorizations. Under the proposed changes, clinicians would […]