CMS final rule 2024: The AMA prior authorization win and the pros and cons of prior authorization

What is the new CMS rule for prior authorization? What is the CMS rule for interoperability? What triggers a prior authorization? Is prior authorization good or bad?

Our guest is Jack Resneck, MD, immediate past president of the American Medical Association. AMA CXO Todd Unger hosts.

📋 CMS final rule 2024 fact sheet: https://www.cms.gov/newsroom/fact-she...

📺 AMA President Dr. Ehrenfeld explains CMS prior authorization final rule:    • CMS prior authorization final rule ex...  

📰 Read about the changes coming in CMS Interoperability Rule 2026: https://www.ama-assn.org/practice-man...

🗣 Get involved! Patients and physicians can share prior authorization stories at: https://fixpriorauth.org/

📊 Access AMA prior authorization resources and research: https://www.ama-assn.org/practice-man...

📚 Free prior authorization templates and model legislation: https://www.ama-assn.org/practice-man...

🏛️ Stay up to date on the AMA's advocacy efforts to fix prior authorization: https://www.ama-assn.org/practice-man...

🩺 The AMA is your powerful ally in patient care. Join now: https://bit.ly/AMAJoinRenew

00:00 AMA Update for March 29, 2024
00:57 CMS final rule summary (CMS 0057, CMS interoperability rule)
02:27 CMS prior authorization rule Medicare Advantage (Medicaid, Medicare Part D)
03:27 Prior authorization appeal process (health insurance appeal, insurance denial)
03:44 CMS prior authorization forms on EHR (electronic health record)
04:59 Prior authorization statistics: https://www.ama-assn.org/system/files...
06:05 What is needed for a prior authorization reform
07:05 Physician story: What is prior authorization in healthcare?
08:45 Prior authorization legislation (Prior authorization laws)
11:20 Prior authorization reform: Health insurance prior authorization rules
12:02 Gold Card prior authorization (gold carding policies, Gold Card Act)
12:21 United Healthcare, Cigna prior authorization
13:34 CMS prior authorization changes and patient access final rule
15:08 AMA efforts on prior authorization policy: https://bit.ly/AMARecoveryPlan_PriorA...
17:18 Medicare prior authorization forms and resources for doctors: fixpriorauth.org

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