RRC leads efforts to improve patient access to care through proper regulation of prior authorization and reduction of administrative burdens.
Regulatory Actions
CMS' Prior Authorization Demonstration for Ambulatory Surgical Center Services
CMS' Prior Authorization Demonstration for Ambulatory Surgical Center Services would require Ambulatory Surgical Centers to obtain prior authorization before providing certain surgical procedures. RRC provided several questions to CMS about this demonstration and expressed concerns regarding the proposed information collection activity.
Read RRC's Comment LetterCMS' Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations (Electronic Prior Authorization) Rule
RRC championed the electronic prior authorization rule supporting provisions that align with the Seniors' Timely Access to Care Act and recommended improvements to transparency requirements and decision timeframes for prior authorization. RRC provided comments to CMS when the rule was proposed, and the rule was finalized on January 17, 2024.
Read RRC's Comment LetterContract Year 2025 Policy and Technical Changes to the Medicare Advantage Program
The 2025 Medicare Advantage (MA) Proposed Rule includes several provisions related to prior authorization of interest to RRC. RRC made recommendations to improve the rule to better protect patients and reduce physician burden relating to prior authorization requirements.
Read RRC's Comment Letter