CMS’ prior authorization reform would reap $15B over 10 years

Article Overview

This article covers a CMS proposed rule focused on improving prior authorization workflows for Medicare Advantage organizations, state Medicaid programs, and other payers. It explains the rule’s general purpose, the expected operational impact for physician practices and hospitals, the implementation timeline, and CMS’ projected time and dollar savings. The piece is most relevant to providers, practice managers, revenue cycle teams, and compliance professionals tracking federal administrative simplification initiatives.