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CMS Releases Long-Awaited Prior Authorization Rule

Jan 17, 2024

On January 17, CMS published its Interoperability and Prior Authorization Final Rule. Once implemented, this rule will require covered payers to establish electronic prior authorization systems, transmit prior authorization decisions within 72 hours for expedited requests and seven calendar days for standard requests, provide a specific reason for denying prior authorization appeals, and publicly report metrics for prior authorization. The release of this final rule comes after years of advocacy efforts focused on prior authorization reform by the Academy and the Regulatory Relief Coalition, and is a significant win for PM&R physicians and their patients. Learn more about AAPM&R’s advocacy on this issue.