By Kim Boyd – We focus on the aspects related to the pharmacy services arena: ePrescribing, electronic prior authorization, and real-time prescription benefit (RTPB). These elements are pivotal in improving patient access to medication and enhancing the efficiency and transparency of the prescription delivery process.
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By Dr. Brian Covino – Adequate access to healthcare remains out of reach for many Americans. Despite progress, underserved communities continue to face significant barriers to quality care, often leading to poorer health outcomes.
March 26, 2024, from 1:00 to 2:00 PM ET: Register and join CMS for their virtual education session on the Interoperability and Prior Authorization final rule. Questions can be submitted beforehand via the registration form.
By David R. Burda – The long-running debate over prior authorization typically is framed around patient care. PA delays or denials prevent patients from receiving medically necessary care when they need it. Within that frame is the administrative burden that PA puts on physicians.
By Kim Boyd – On January 17, 2024, CMS unveiled the final rule aimed at advancing interoperability and enhancing prior authorization processes. This regulation leverages API technology to drive transparency, efficiency, and reduce provider, patient, and payer burden.
As part of the Biden-Harris Administration’s ongoing commitment to increasing health data exchange and strengthening access to care, the Centers for Medicare & Medicaid Services finalized the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F).
By Thad Salido MD – The future of healthcare extends beyond treating illnesses; it’s about the ability to foresee and prevent them. With the emergence of AI and the rapid expansion of comprehensive population health data, we stand at the cusp of a healthcare revolution.
By Teri Gatchel-Schmidt – In the pursuit of delivering high-quality patient care, the complexities of healthcare management continually present challenges and regulation changes. Example, the Prior Authorization process, overloading medical staffs with administrative and resource demands.
By Matthew D. Bayley MD – Each year the Medical Group Management Association surveys hundreds of group practices to assess how industry regulations are impacting them. Just as in previous years, the most recent survey shows things are getting worse, not better.