RRC leads efforts to improve patient access to care through proper regulation of prior authorization and reduction of administrative burdens.
Regulatory Actions
Wasteful and Inappropriate Service Reduction (WISeR) Model
RRC submitted a letter to CMS expressing strong concerns about the Wasteful and Inappropriate Service Reduction (WISeR) Model in the Medicare Fee-for-Service (FFS) program. The payment model would increase the use of prior authorization in FFS Medicare, likely resulting in added administrative burden for providers and delays in beneficiary access to timely care.
Read RRC's Comment LetterCMS' Contract Year 2026 Medicare Advantage Proposed Rule
RRC provided comments on CMS' Contract Year 2026 Medicare Advantage Proposed Rule, which included several provisions of interest to RRC, including prior authorization, provider directories, MA plans' internal coverage criteria policies, and the Medicare Loss Ratio.
Read RRC's Comment LetterCMS' Request for Information on Medicare Advantage Data
RRC responded to CMS' Request for Information about additional data collection that may be useful with respect to the MA program. In the comments RRC emphasized that additional data collection from MA plans can provide additional insight into the impact of prior authorization.
Read RRC's Comment Letter